Utility of Stress cardiography to identify myocardial ischemia

ABSTRACT

The dobutamine echocardiography takes more and more an important place in diagnosis, prognosis and therapeutics strategies of the coronary disease. We prospectively enrolled 130 consecutive patients followed for a coronary insufficiency. The aim of determinating the diagnostic value of the dobutamine echocardiography in the myocardial ischemia compared with the classic means as the exercise test and the myocardial scintigraphy. Our results are comparable to the data of the literature, the dobutamine echocardiography is more specific than the exercise test and the myocardial scintigraphy [96%, 61% and 53%], more sensitive than exercise test [75% versus 47%] but less sensitive than the myocardial scintigraphy [75% versus 96%]. The stress echocardiography has the best diagnosis precision 87%, against 72% for the scintigraphy and 56% for the exercise test. The dobutamine echocardiography is a very feasible, tolerated well exam and especially very reliable in term of detection of the coronary disease in the feminine population, with a sensibility at 66,7%, a specificity at 100% and a diagnostic precision at 92%, also in patient with hypertension the stress echocardiography is much more specific and reliable than the exercise test [100% vs 22% and 93% vs 54%, respectively], and it's superior to the exercise test in the presence of electric signs of systolic excess load and to the myocardial scintigraphy in case of left ventricular hypertrophy. The dobutamine echocardiography can be considered as safety and reliable means of investigation of the coronary insufficiency