Document Detail


Advantages of exercise echocardiography in comparison to dobutamine echocardiography in the diagnosis of coronary artery disease in hypertensive subjects.
MedLine Citation:
PMID:  11687926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of the study was to compare the efficacy and safety of two stress echocardiography methods, exercise and dobutamine, in the diagnosis of coronary artery disease in hypertensive patients with angina. PATIENTS AND METHODS: A total of 197 treated hypertensive patients, age 53 +/- 9 years (65 women) with no history of myocardial infarction referred for coronary angiography were prospectively investigated with exercise electrocardiography (ECG), exercise and dobutamine echocardiography. RESULTS: Sensitivity of the exercise ECG, exercise echocardiography and dobutamine echocardiography did not differ (77%, 82% and 75%). Negative predictive value of exercise ECG was significantly lower than exercise echocardiography (64% vs 79%, P < 0.01). Specificity and positive predictive value of exercise ECG were markedly lower than exercise and dobutamine echocardiography (57%, 96%, 98% and 72%, 97%, 98%, P < 0.0001 for both stress echocardiography vs ECG). Specificity and sensitivity of diagnostic methods were not influenced by the presence of echocardiographic left ventricular hypertrophy. Dobutamine infusion in comparison to exercise was more often associated with substantial arterial blood pressure rise or fall (7% vs 2%, P < 0.05) and with simple ventricular ectopy (15,7% vs 6,1%, P < 0.05). CONCLUSIONS: In hypertensive patients with the symptoms of angina, both stress echo methods are significantly more specific than the exercise ECG test. Maximal exercise is associated with less frequent side effects than infusion of dobutamine, so exercise echocardiography may be preferred in the diagnosis of angina in hypertensive patients.
Authors:
T Pasierski; H Szwed; B Malczewska; B Firek; M Kośmicki; M Rewicki; I Kowalik; Z Sadowski
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of human hypertension     Volume:  15     ISSN:  0950-9240     ISO Abbreviation:  J Hum Hypertens     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-05     Completed Date:  2001-12-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  805-9     Citation Subset:  IM    
Affiliation:
Department of Coronary Artery Disease, National Institute of Cardiology, Warszawa, Poland. pasier@medprakt.pl
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Angina Pectoris / complications,  diagnosis
Arrhythmias, Cardiac / complications,  diagnosis
Coronary Angiography
Coronary Artery Disease / complications,  diagnosis*
Echocardiography, Stress* / methods*
Equipment Safety
Exercise Test*
Female
Humans
Hypertension / complications,  diagnosis*
Hypertrophy, Left Ventricular / complications,  diagnosis
Male
Middle Aged
Predictive Value of Tests
Prognosis
Prospective Studies
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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