Localization Of Coronary Disease Research Articles

The value of dobutamine stress echocardiography for the detection of coronary artery disease in women

To determine whether there were any gender-based differences in the detection of coronary artery disease by dobutamine stress echocardiography, we examined 288 patients (187 men and 101 women) who underwent coronary angiography within 8 weeks of dobutamine stress testing. Abnormal test results were indicated by left ventricular wall motion abnormalities at rest, which did not improve or worsen, or inducible wall motion abnormalities in two or more segments with dobutamine. Overall, dobutamine stress echocardiography showed a high sensitivity, specificity, and accuracy in both men and women: 85%, 96%, and 88% and 90%, 79%, and 86%, respectively. The sensitivity in detecting significant coronary artery disease in our population was not influenced by gender. However, the sensitivity of the test was influenced by the extent and location of coronary disease and the pattern of left ventricular hypertrophy. The sensitivity was 80% in patients with single-vessel disease, whereas the sensitivity was 91% in patients with multivessel disease. In addition, patients with single-vessel disease had lower sensitivity when the abnormality was located in the left circumflex coronary artery territory (59% versus 86% in the left anterior descending and right coronary territories). Our data indicated that there is no gender-based difference in the sensitivity and specificity of dobutamine stress echocardiography in detecting coronary artery disease and that the limitations of the test should be attributed to the extent and location of coronary disease. (J Am Soc Echocardiogr 1997;10:811-17.)

Effect of prior myocardial infarction and extent and location of coronary disease on accuracy of exercise echocardiography

Exercise echocardiography is an emerging technique for the evaluation of patients with suspected coronary artery disease. In this study, rest and immediate postexercise echocardiograms were performed in 123 patients who were stratified on the basis of prior myocardial infarction and the number and location of coronary artery stenoses at cardiac catheterization. The location of wall motion abnormalities on rest and postexercise studies was correlated with the location of coronary artery stenoses. The sensitivity of exercise echocardiography for detecting coronary artery disease in patients with multivessel disease was 97% in those with and 86% in those without prior infarction. The corresponding sensitivity for patients with single vessel disease was 100% and 72%, respectively. Multivessel disease was present in 59 patients, but specifically identified as such in only 32 (54%). Normal rest and exercise echocardiograms were seen in 12 patients with coronary artery disease, 8 of whom had single vessel disease. It is concluded that the subjective analysis of the exercise echocardiogram accurately identifies the majority of patients with coronary artery disease. Its sensitivity is greatest in those with multivessel coronary disease. It is limited in those with single vessel coronary disease and in accurately identifying the subset of patients with multivessel disease.

Correlation of treadmill exercise electrocardiogram with arteriographic location of coronary disease

Correlation of treadmill exercise electrocardiogram with arteriographic location of coronary disease