Comparison of exercise stress test with dobutamine stress echocardiography and dipyridamole stress echocardiography in non invasive diagnosis of coronary artery disease

Koroner arter hastalığı'nın non-invaziv tanısında egzersiz elektrokardiyografi ile dobutamin stres ekokardiyografi ve dipiridamol stres ekokardiyografinin karşılaştırlıması

Tahir DURMAZ,Halil Lütfi KISACIK,Kurtuluş ÖZDEMİR,Abdurrahman OĞUZHAN,Bülent ALTUNKESER,Ercan VAROL,Tevfik KURAL,Siber GÖKSEL

Abstract

Comparison of Exercise Stress Test with Dobutamine Stress Echocardiyography and Dipyridamole Stress Echocardiography in non Invasive Diagnosis of Coronary Artery Disease The aim of this study was to compare the value of exercise test with dobutamine stress echocardiyography (DSE) and diprydamole stress echocardiyography (DPSE) for the diagnosis of coronary artery disease. After stopping antianginal treatment, 31 patients with either, suspected or proven coronary artery disease underwent treadmill electrocardiography (EKG) , DSE (starting 5 jjgr/kg/min; to maximum 40 jigr/kg/min) and DPSE (0.84mg/kg in 10 minute). Dobutamine stress echocardiography and DPSE showed higher sensitivity than exercise testing (91% and 64%, p<0.05; 82% and 64%, p<0.05, respectively); this finding was due to high sensitivity of DSE and DPSE in single-vessel coronary artery disease and interpreting basal wall motion abnormality as coronary artery disease (78% and 44%, P<0.05; 56% and 44%, p>00.5; respectively). However the sensitivity of all three tests were similar in multi-vessel coronary artery disease (100%, 100% and 85%, p>0.05; respectively). DPSE showed higher specificity than both DSE and exercise EKG; but the difference betwen DPSE and DSE was not significant statistically (100%, %89 and 78%, p<0.05; respectively). The diagnostic accuracy of DSE and DPSE was higher than that of exercise EKG (90% and 68%, p<0.05; 87% and •68% p<0.05; respectively); however the difference between the diagnostic accuracy of DSE and DPSE was not significant statistically (90% and 87%, p>0.05). There were not any major complications observed due to these three tests. DSE and DPSE are superior to exercise EKG in the diagnosis of coronary artery disease and can act as an alternative to exercise EKG.

Özet

Koroner arter hastalığının (KAH) tanısında egzersiz testi ile dobutamin stres ekokardiyografî (DSE) ve dipiridamol stres ekokardiyografî'nin (DPSE) değerini karşılaştırmak için, şüpheli ya da kanıtlanmış KAH bulunan 31 hastaya antianginal tedaviye a-ra verildikten sonra treadmill egzersiz elektrokardiyografi île DSE (5 jj.gr/kg/dk'dan başlıyarak maksimum 40 jugr/kg/dk'ya kadar) ve DPSE (0.84mg/kg lOdk içinde ) yapıldı. DSE ve DPSE egzersiz EKG'den daha yüksek sensitivite gösterdi (sırası ile %91 ve %64, p 0,05), buna karşılık her üç testin de sensitivitesi çok-damar hastalığında benzerdi (sırası ile%100, %100 ve %85 p>0,05). DPSE hem DSE hem de egzersiz EKG'den yüksek spesifisite gösterdi ancak DPSE ile DSE arasındaki fark istatiksel olarak anlamlı değildi (sırası ile %100, %89 ve %78; p 0,05). Her üç test sırasında major bir komplikasyon oluşmadı. DSE ve DPSE'nin KAH tanısında egzersiz elektrokardiyogra¬fiye üstünlükleri vardır ve egzersiz EKG 'ye kabul edilebilir bir alternatiftirler.