Document Detail


Comparison of the diagnostic potential of four echocardiographic stress tests shortly after acute myocardial infarction: submaximal exercise, transesophageal atrial pacing, dipyridamole, and dobutamine-atropine.
MedLine Citation:
PMID:  8644637     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study assessed and compared the diagnostic potential of submaximal exercise, transesophageal atrial pacing, dipyridamole, and dobutamine-atropine stress echocardiography tests shortly after acute myocardial infarction. In 121 study patients, 325 digital echocardiographic stress tests were attempted 10 to 11 days after acute myocardial infarction: 83 submaximal exercise tests, 121 high-dose dipyridamole echocardiography tests (DET), 69 transesophageal atrial pacing tests (< 150 beats/min), and 52 dobutamine tests, starting at 10 microgram/kg per minute, increasing stepwise to 40 microgram kg/min, and coadministering atropine in 12 patients (dobutamine-atropine stress echocardiography [DASE]). Results were correlated to a coronary artery diameter stenosis > or = 50% as determined by quantitative angiography. Feasibility to perform submaximal exercise echocardiography, atrial pacing echocardiography, DET, and DASE was 89%, 52%, 98%, and 88%, respectively. Atrial pacing was not tolerated by 18 patients and refused by 6 (9%). Severe but not life-threatening side effects were hypotension in DET (2%) and tachyarrhythmias in DASE (6%). Test positivity in multivessel disease with submaximal exercise, DET, and DASE was 55%, 93%, and 90%, respectively, and in 1-vessel disease 47%, 65%, 71%, and for atrial pacing, 82%, respectively. We conclude that submaximal exercise has limited sensitivity and atrial pacing limited feasibility. The pharmacologic stressors provide a useful, safe diagnostic approach: DET with slightly lower sensitivity in 1-vessel disease and DASE with insignificantly less feasibility.
Authors:
K Schröder; H Völler; H Dingerkus; H Münzberg; R Dissmann; T Linderer; H P Schultheiss
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  77     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-07-16     Completed Date:  1996-07-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  909-14     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Klinikum Benjamin Franklin, Free University of Berlin, Germany.
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MeSH Terms
Descriptor/Qualifier:
Atropine / diagnostic use
Cardiac Pacing, Artificial / adverse effects,  methods
Cardiotonic Agents / diagnostic use
Constriction, Pathologic
Dipyridamole / adverse effects,  diagnostic use
Dobutamine / adverse effects,  diagnostic use
Echocardiography / methods*
Exercise Test / methods*
Humans
Myocardial Infarction / ultrasonography*
Sensitivity and Specificity
Vasodilator Agents / diagnostic use
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Vasodilator Agents; 34368-04-2/Dobutamine; 51-55-8/Atropine; 58-32-2/Dipyridamole

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


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