TRANSESOPHAGEAL DOBUTAMINE STRESS ECHOCARDIOGRAPHY IN CORONARY ARTERY DISEASE

多巴酚丁胺负荷超声心动图是一个有用的工具， 冠状动脉疾病患者在不同的临床环境中。 然而，它的使用受到了很大的限制， 有相当多的患者患有这种疾病。 一个替代 心脏成像的方法是经食道的 超声心动图 为了确定经食管 超声心动图联合多巴酚丁胺负荷试验评价 冠状动脉疾病患者，我们在50例 行冠状动脉造影术的患者。四十三 患者为男性;年龄为59 ± 10岁。 图像是用 双平面（40例患者）或全平面（10例患者）探头。 多巴酚 输注剂量从2.5 μ g/kg/min逐步增加至40 μ g/kg/min。 将左心室分为16个节段，以了解节段性室壁运动 分析. 充分的内窥镜可视化，以允许分析 在更多的心肌中实现了局部室壁运动， 与经胸超声心动图相比， 50例患者中有40例有明显狭窄（超过70%的动脉狭窄）， 至少1个主要冠状动脉）。 多巴酚丁胺诱导新的室壁运动 在35例冠心病患者中， 冠状动脉正常 局部室壁运动异常 17例至少有2支冠状动脉分布 在19例多支冠状动脉疾病患者中， 21例单支冠状动脉疾病患者中有1例。 因此，在本发明中， 本试验的敏感性为88%，特异性和阳性率分别为 预测值为100%。 仅2例患者停止了试验 因为对探针不耐受。 无并发症发生， 我们的研究。 因此，这项研究表明，经食管 多巴酚丁胺负荷超声心动图是一个有用的工具， 冠状动脉疾病，因此应考虑在患者 接受负荷超声心动图检查， 超声波窗口

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.