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Arch. cardiol. Méx ; 72(2): 105-114, abr.-jun. 2002.
Artigo em Espanhol | LILACS | ID: lil-329840

RESUMO

OBJECTIVE: To assess the usefulness of transesophageal dobutamine stress echocardiography (TEDSE), to identify patients with coronary artery disease. METHODS: Patients referred for TEDSE with coronary angiography were included. Images were digitized in systolic cine-loop at baseline, with low dose-dobutamine (14.4 +/- 5 micrograms/kg/min), with high dose-dobutamine (28.7 +/- 10.5 micrograms/kg/min) and during recovery, and then analyzed by two observers. The left ventricle was divided into 16 segments according to coronary distribution, and the study was considered abnormal if there was a new or worsening of the segmental wall motion abnormality. Quantitative coronary angiographies were independently assessed, and lesions considered significant if they had > or = 70 diameter stenosis. RESULTS: Sixty eight patients were included. TEDSE sensitivity, specificity, and accuracy were 93, 89.7, and 91.1, respectively. TEDSE correctly detected 7/7 single vessel disease and 20/22 multiple vessel disease patients. Twelve-lead ECG had a sensitivity, specificity, and accuracy of 38.3, 91.8, and 74.5 respectively, to detect the same lesions. CONCLUSIONS: TEDSE is feasible, safe, sensitive, and specific to detect significant coronary lesions. It should be considered in patients with suboptimal acoustic window or poor visualization of endocardial borders.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Dobutamina , Ecocardiografia Transesofagiana , Cardiopatias , Isquemia Miocárdica , Simpatomiméticos , Algoritmos , Angina Pectoris , Angiografia Coronária , Doença das Coronárias , Interpretação Estatística de Dados , Doenças das Valvas Cardíacas , Ecocardiografia Transesofagiana , Eletrocardiografia , Cardiopatias , Isquemia Miocárdica/diagnóstico , Sensibilidade e Especificidade , Fatores de Tempo
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