[Comparison of ergometer and dipyridamole echocardiography in patients with suspected coronary heart disease].
To compare exercise echocardiography (EE) and dipyridamole echocardiography (DE), echocardiographically assessable wall motion abnormalities were examined in 80 patients with suspected coronary artery disease. Issues of the study were the evaluation of feasibility, sensitivity, specificity, and the necessity of recordings under dynamic maximal stress (peak exercise) on a bicycle. DE had a better feasibility than EE (95% vs. 84%, p < 0.05). Eleven percent of patients had no interpretable echocardiograms during peak exercise. However, after peak exercise all patients had adequate images. In order to calculate sensitivity of the methods, coronary stenoses of at least 70% on coronary angiograms were considered. Sensitivity of DE (73%) was similar to that of EE (75%). In patients with single-vessel disease both methods were less sensitive (63% and 67%) than in patients with multi-vessel disease (86% each). However, compared with stress ECG both methods proved to be superior (p < 0.05). In 31% of patients with coronary artery disease only recordings during peak exercise led to pathological findings. By not applying the EE during peak exercise the results of these patients would have been falsely negative i.e. regarded as normal. The specificity of DE (87%) was similar to that of EE (80%). In conclusion, there are no significant differences between DE and EE except feasibility and side-effects. Both methods are superior to stress ECG in terms of sensitivity regarding detection of ischemic myocardium. However, their precision needs to be evaluated differentially: Sensitivity was higher among patients with multi-vessel disease compared with those with single-vessel disease.(ABSTRACT TRUNCATED AT 250 WORDS)
Deutsch
H J
HJ
Klinik III für Innere Medizin, Universität zu Köln.
Schenkel
C
C
Klaer
R
R
Curtius
J M
JM
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000503:physiopathology; D017023:Coronary Angiography / Q000187:drug effects; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology; D004176:Dipyridamole; D004452:Echocardiography / Q000187:drug effects; D005080:Exercise Test / Q000187:drug effects; D005240:Feasibility Studies; D005260:Female; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects / Q000502:physiology; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology
D004176:Dipyridamole
Vergleich von Ergometer- und Dipyridamol-Echokardiographie bei Patienten mit vermuteter koronarer Herzkrankheit.