TRANSESOPHAGEAL DOBUTAMINE STRESS ECHOCARDIOGRAPHY IN CORONARY ARTERY DISEASE

多巴酚丁胺负荷超声心动图是一种有用的评估工具。 对不同临床环境下的冠心病患者进行比较。 然而，它的使用受到较差的超声窗口的显著限制 有相当数量的这种情况的患者。另一种选择 心脏成像的方法是经食道 超声心动图。确定经食道手术的效用 超声心动图联合多巴酚丁胺负荷评价 冠心病患者，我们在50名患者中进行了研究 未经选择接受冠状动脉造影术的患者。四十三个 患者为男性，年龄59±10岁。图像是通过一个 双平面(40例)或全平面(10例)探头。多巴酚丁胺 由2.5微克/公斤/分逐步递增至40微克/公斤/分。这个 将左心室分为16个节段进行节段性室壁运动 分析。充分的心内膜可视化以允许分析 节段性室壁运动在更多的心肌中实现 经食道节段超声心动图与经胸超声心动图比较。 50名患者中有40名有明显的狭窄(超过70%的AT 至少1条主要冠状动脉)。多巴酚丁胺引起的新的室壁运动 35例冠心病患者异常及无一例异常 冠状动脉正常。心脏节段性室壁运动异常 在17例患者中观察到至少2条主要冠状动脉的分布 在19例多支冠状动脉病变患者中，仅 21例单支冠状动脉病变患者中1例。因此， 该试验的敏感性为88%，具有特异性和阳性 预测值为100%。只有2名患者停止了测试 因为对探测器的不容忍。所有患者均未发生并发症 我们的研究成果。因此，这项研究表明，经食道 多巴酚丁胺负荷超声心动图是一种有用的评估工具。 冠状动脉疾病，因此应考虑患者 接受负荷超声心动图检查的患者经胸超声心动图检查 超声窗。

Dobutamine stress echocardiography is a useful tool for the assessment of patients with coronary artery disease in different clinical settings. However, its use is significantly limited by poor ultrasound window in a considerable number of patients with this condition. An alternative approach for imaging of the heart has been transesophageal echocardiography. To determine the utility of transesophageal echocardiography combined with dobutamine stress for the evaluation of patients with coronary artery disease, we performed studies in 50 unselected patients who underwent coronary angiography. Forty-three patients were male; age was 59+/-10 years. Images were obtained with a biplane (40 patients) or an omniplane (10 patients) probe. Dobutamine was infused with stepwise increases from 2.5 to 40 microg/kg/min. The left ventricle was divided into 16 segments for regional wall motion analysis. Adequate endocardial visualization to permit analysis of regional wall motion was achieved in a greater number of myocardial segments with transesophageal compared to transthoracic echocardiography. Forty of the 50 patients had significant stenosis (more than 70% of at least 1 major coronary artery). Dobutamine induced new wall motion abnormality in 35 patients with coronary artery disease and in no patient with normal coronary arteries. Regional wall motion abnormalities in the distribution of at least 2 major coronary arteries were observed in 17 of the 19 patients with multi-vessel coronary artery disease and in only 1 of the 21 patients with single-vessel coronary artery disease. Thus, the sensitivity of the test was 88%, with a specifity and a positive predictive value of 100%. In only 2 patients the test was stopped because of intolerance to the probe. No complications occurred in any of our studies. Thus, this study indicates that transesophageal dobutamine stress echocardiography is a useful tool for the assessment of coronary artery disease and therefore should be considered in patients undergoing stress echocardiography who have suboptimal transthoracic ultrasound window.