Adenosine triphosphate versus dobutamine stress contrast echocardiographyin diagnosis of coronary artery disease

Abstract

Objective To compare the application value of adenosine triphosphate versus dobutamine stress contrast echocardiography in the diagnosis of coronary heart disease. Methods Eighty-six patients with coronary artery disease or suspected coronary artery disease underwent both adenosine triphosphate and dobutamine stress contrast echocardiography, and coronary angiography (CAG) or coronary CT angiography (CTA) was also performed at the Cardiovascular Center of Dongguan Kanghua Hospital from November 2018 to June 2019. Coronary arterial stenosis ≥50% and ≥75% were used as the diagnostic criteria for coronary artery disease, respectively, and CAG or CTA results were used as the standard for diagnosis. Four-scale table was used to calculate the sensitivity, specificity, and accuracy of adenosine triphosphate and dobutamine stress contrast echocardiography for the diagnosis of coronary heart disease. Results When using coronary arterial stenosis ≥50% as the diagnostic standard for coronary heart disease, the sensitivity, specificity, and accuracy of adenosine triphosphate stress contrast echocardiography for the diagnosis of coronary heart disease were 56%, 96%, and 77%, respectively; the corresponding percentages of dobutamine stress contrast echocardiography were 76%, 96%, and 86%. The sensitivity and accuracy of the latter were higher than those of the former. When using coronary arterial stenosis≥75% as the diagnostic standard for coronary heart disease, the sensitivity, specificity, and accuracy of adenosine triphosphate stress contrast echocardiography for the diagnosis of coronary heart disease were 81%, 97%, and 83%, respectively; the corresponding percentages of dobutamine stress contrast echocardiography were 88%, 98%, and 95%. The diagnostic sensitivity, specificity, and accuracy of the latter were still higher than those of the former. Conclusion The sensitivity, specificity, and accuracy of dobutamine stress contrast echocardiography for the diagnosis of coronary heart disease are higher than those of adenosine triphosphate stress contrast echocardiography. The former has good diagnostic value for extramural obstructive coronary heart disease, and the latter is suitable for patients with severe coronary artery stenosis. The combination of the two can increases the safety and diagnostic sensitivity. Key words: Adenosine triphosphate; Dobutamine; Stress contrast echocardiography; Coronary artery disease