Dobutamine stress radionuclide ventriculography for the detection of coronary artery disease.
Thirty patients were prospectively studied to assess the value of radionuclide ventriculography (RNV) during step-wise dobutamine infusion for the detection of coronary artery disease (CAD). Radionuclide ventriculography was performed under basal conditions and during dobutamine infusion at each 10 micrograms kg-1 min-1 dose increment from 10 to a maximum of 40 micrograms kg-1 min-1. The test response was considered positive if the ejection fraction (EF) decreased by more than 5% or if segmental contraction abnormalities developed. Dobutamine stress testing was well tolerated, no complications and no significant arrhythmia were observed. In nine of 11 patients without CAD, EF increased more than 5% of the rest value and the left ventricular wall motion was normal in 10 of them during dobutamine infusion (specificity 91%). In 18 of 19 patients with CAD, new wall motion abnormalities (WMA) were identified in segments corresponding to the arterial lesions diagnosed by angiography (sensitivity 94%). Ejection fraction response was significantly different in normal subjects and in patients with CAD: 11 +/- 5.9% versus 1.9 +/- 9.5% (P < 0.01). However, abnormal EF response was found in seven of 19 CAD patients and development of new WMA was found to be a more sensitive and specific parameter than EF response for dobutamine RNV. It is concluded that dobutamine RNV is an accurate, widely available and cost-effective test for detecting CAD, especially in patients unable to exercise.
Günalp
B
B
Department of Nuclear Medicine, Gülhane Military Medical Academy and Faculty, Ankara, Turkey.
Uyan
C
C
Dokumaci
B
B
Ozgüven
M
M
Vardareli
E
E
Oztürk
E
E
Ozkan
M
M
Işik
E
E
Bayhan
H
H
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D004280:Dobutamine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015635:Radionuclide Ventriculography / Q000379:methods*
D004280:Dobutamine