ABSTRACT
OBJECTIVE: To compare the usefulness of dobutamine-atropine stress echocardiography in the diagnosis of coronary artery disease among men and women. METHODS: We have consecutively studied 137 men and 99 women without a previous history of coronary artery disease who underwent dobutamine-atropine stress echocardiography and coronary angiography afterwards. RESULTS: Significant coronary artery disease was detected in 102 men and 42 women (74% and 42% respectively; p < 0.001). 64% of the women had single-vessel versus 45% of the men (p < 0.05). Dobutamine-atropine stress echocardiography was positive in 78 men and 35 women. Sensitivity, specificity and diagnostic accuracy of the test were 72%, 88% and 76% for men and 69%, 89% and 83% for women (p = NS). Positive predictive value was higher in men (95% in men versus 83% in women; p < 0.05) and negative predictive value was significantly greater in women than in men (79% versus 52%; p < 0.01). CONCLUSION: Sensitivity, specificity and diagnostic accuracy of dobutamine-atropine stress echocardiography is not affected by gender. Positive predictive value is higher in men and negative in women owing to the differences in both sexes of the prevalence of coronary artery disease.
Subject(s)
Cardiotonic Agents , Dobutamine , Echocardiography/methods , Myocardial Ischemia/diagnostic imaging , Sex Characteristics , Aged , Atropine/administration & dosage , Cardiotonic Agents/administration & dosage , Cardiotonic Agents/adverse effects , Coronary Angiography , Dobutamine/administration & dosage , Dobutamine/adverse effects , Echocardiography/adverse effects , Echocardiography/instrumentation , Echocardiography/statistics & numerical data , Female , Humans , Male , Middle Aged , Risk Factors , Sensitivity and SpecificityABSTRACT
Congenital mitral valve anomalies are uncommon and their incidence in adults is very unusual. Transthoracic echocardiography is essential for their diagnosis. In this study two adult patients with parachute mitral valve and one with isolated cleft of mitral valve are described. An echocardiographic exam was decisive in obtaining the diagnosis for each of these patients. Clinical aspects, typical echocardiographic findings and therapeutical approaches of these entities are discussed.
