Dobutamine stress echocardiography implications, feasibility and initial experience

ABSTRACT

Dobutamine Stress Echocardiography [DSE] is a relative and recent development with promising results in evaluation of CAD, viable myocardium and pre-operative assessment for non-cardiac surgery. We performed DSE on 100 consecutive patients with mean age of 51.83 years [range 30-90 years], male female ratio of 21. Two third patients were unable to perform exercise due to various medical reasons, remaining had orthopedic limitation or debility. 76 percent were evaluated for coronary artery disease [CAD], 16 percent for viabilty study, 8 percent for post CABG evaluation. New regional wall motion abnormality or worsening of existing abnormality at rest was considered positive for test. Biphasic response [improvement at low dose and worsening at peak dose] was the most specific indicator for viability. Test stopped due to positive ischemic response in 5.1 percent patients. 49 percent were negative. One third had minor side effects. Most patients for viability study showed biphasic response, only few revealed persistent improvement with peak dose. In CABG, all grafts were patent, however native disease was detected. Excellent correlation observed with few available coronary angiograms. In conclusion DSE is safe, feasible, cost effective, comparable modality -for evaluation of suspect or known CAD and viable myocardium