Dobutamine stress echocardiography: sensitivity, specificity, and predictive value for future cardiac events.
Dobutamine stress echocardiography: sensitivity, specificity, and predictive value for future cardiac events.
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多巴酚丁胺负荷超声心动图：敏感性、特异性和对未来心脏事件的预测价值。
DOI：
10.1016/0002-8703(94)90378-6
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发表时间：
1994
影响因子：
4.8
通讯作者：
Cheirif,J
中科院分区：
文献类型：
--
作者：
Afridi,I;Quiñones,MA;Zoghbi,WA;Cheirif,J
我们进行了一项回顾性研究，以确定多巴酚丁胺负荷超声心动图(DE)是否可用于已知或可疑冠心病(CAD)患者的风险分层。研究人群包括77名在我们机构接受DE的患者。方案包括在基线时进行超声心动图，然后在多巴酚丁胺静脉滴注期间进行成像，从10μg/kg/min开始，每3分钟递增10μg/kg/min，最大剂量为40μg/kg/min。进行DE的原因包括术前心脏评估(30例)、胸痛(23例)、缺血评估(18例)和疑似再狭窄(6例)。DE根据室壁运动反应分为正常(DE前和DE中)、固定性异常(DE前异常，DE中无变化)、缺血(DE中新发室壁运动异常)。平均随访时间为10个月。发生心脏事件14例。这些患者包括7名充血性心力衰竭患者，6名心肌梗塞患者，1名心源性死亡患者。正常的室壁运动反应(n=40)与较低的心脏事件发生率(5%)有关，而10例有缺血反应的患者中有5例(50%)有事件发生。在室壁运动固定异常的患者中，心脏事件的风险为中等(26%)。DE预测未来心脏事件的总体敏感性为85%。在45名在DE后2个月内接受冠状动脉造影术的患者中，这项测试检测到CAD的敏感性为71%。综上所述，DE时的室壁运动反应可用于识别未来心脏事件的高危患者。
We conducted a retrospective study to determine whether dobutamine stress echocardiography (DE) can be used for risk stratification of patients with known or suspected coronary artery disease (CAD). The study population consisted of 77 patients who underwent DE at our institution. The protocol consisted of an echocardiogram at baseline followed by imaging during intravenous dobutamine infusion starting at 10 μg/kg/min with increments of 10 μg/kg/min every 3 minutes to a maximum dose of 40 μg/kg/min. The reasons for performing DE included preoperative cardiac evaluation (30), chest pain (23), assessment of ischemia (18), and suspected restenosis (6). DE was classified according to wall motion response as normal (before and during DE), fixed abnormal (abnormal before with no change during DE), or ischemic (new wall-motion abnormality during DE). Mean duration of follow-up was 10 months. Cardiac events occurred in 14 patients. These included congestive heart failure in seven patients, myocardial infarction in six, and cardiac death in one. A normal wall-motion response (n = 40) was associated with a low incidence of cardiac events (5%), whereas 5 of 10 patients (50%) with an ischemic response had events. The risk of cardiac events was intermediate (26%) in patients with fixed abnormal wall motion. Overall sensitivity of DE for predicting future cardiac events was 85%. In 45 patients who underwent coronary angiography within 2 months of DE, the test detected CAD with a sensitivity of 71%. In conclusion, the wall-motion response during DE may be used for identifying patients at high risk for future cardiac events.