DOBUTAMINE ECHOCARDIOGRAPHY IN PATIENTS WITH CHEST PAIN AND NORMAL CORONARIES

胸痛和冠状动脉正常患者的多巴酚丁胺超声心动图检查

• 批准号: 3757732
• 负责人: J A PANZA
• 金额: --
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3757732
• 关键词: angina pectoris; angiography; blood vessel disorder; cardiovascular disorder diagnosis; coronary artery; coronary disorder; diagnosis quality /standard; dobutamine; echocardiography; electrocardiography; exercise; heart rate; human subject; myocardial ischemia /hypoxia; prognosis; stress; vasomotion

We have shown that transesophageal dobutamine stress echocardiography is a safe and reliable method for the assessment of patients with coronary artery disease. Accordingly, we sought to determine whether patients with chest pain and normal coronary arteries have similar evidence of myocardial ischemia during dobutamine stress assessed by means of transesophageal echocardiography. To this end, we studied 43 patients with chest pain and normal coronary angiograms (13 men age 49q10 years), 13 of whom had ischemic-appearing electrocardiographic responses to treadmill exercise. We also performed the same technique in 62 patients with coronary artery disease and in 21 normal volunteers. Dobutamine stress induced chest pain in 84% of patients with chest pain and normal coronary arteries, in 50% of coronary artery diseased patients, and in none of the normal volunteers. Ischemic-appearing electrocardiographic changes developed in 28% of patients with chest pain and normal coronary arteries, in 51% of patients with coronary artery disease, and in only 5% of the normal volunteers. Wall motion abnormalities occurred in none of the patients with chest pain and normal coronary arteries, in 89% of the patients with coronary artery disease and in none of the normal volunteers. Hence, in spite of the successful provocation of typical chest pain and/or electrocardiographic changes, patients with chest pain and normal coronary arteries did not have evidence of myocardial ischemia during transesophageal dobutamine stress echocardiography. Therefore, this technique appears as a useful and safe method for the identification of patients with chest pain of nonischemic origin.

我们已经证明，经食管多巴酚丁胺负荷超声心动图， 一种安全可靠的评估冠心病患者的方法 动脉疾病 因此，我们试图确定患者是否 胸痛和正常冠状动脉有类似的证据， 多巴酚丁胺负荷时心肌缺血的评价 经食管超声心动图 为此，我们研究了43名患者， 胸痛和冠状动脉造影正常（13名男性，年龄49岁，10岁）， 其中13人出现缺血性心电图反应， 跑步机运动 我们还在62名患者中进行了相同的技术 冠心病患者和21名正常志愿者。 多巴酚 应激性胸痛患者中84%的胸痛与正常 冠状动脉，50%的冠状动脉疾病患者， 没有一个正常的志愿者。 缺血样心电图 28%的胸痛和冠状动脉正常的患者发生了变化， 51%的冠状动脉疾病患者， 正常志愿者的5%。 无室壁运动异常 在胸痛和冠状动脉正常的患者中， 冠心病组和非冠心病组 志愿者 因此，尽管成功的挑衅典型的 胸痛和/或心电图变化，胸痛患者 正常冠状动脉没有心肌缺血的证据 在经食管多巴酚丁胺负荷超声心动图检查中。 因此，我们认为， 这项技术似乎是一种有用和安全的方法， 非缺血性胸痛的患者。