title: Comparative evaluation of bicycle and dobutamine stress echocardiography with perfusion scintigraphy and bicycle electrocardiogram for identification of coronary artery disease.
abstract: In 66 patients with suspected coronary artery disease (CAD), exercise electrocardiography (ECG), exercise echocardiography, dobutamine stress echocardiography (dosage, 5 to 40 micrograms/kg/min), single-photon emission computed tomography (SPECT) using methoxy-isobutyl-isonitrile (MIBI) and coronary angiography were performed prospectively to compare methods for detecting CAD. CAD was defined as 70% luminal area stenosis in at least 1 coronary artery at coronary angiography. Significant CAD was present in 50 patients. Compared with exercise ECG, exercise echocardiography, dobutamine stress echocardiography and MIBI-SPECT had a significantly higher sensitivity (52% vs 80, 79 and 89%; p < 0.01, p < 0.01 and p < 0.001, respectively). There were no significant differences in sensitivity between exercise echocardiography, dobutamine stress echocardiography and MIBI-SPECT. Specificity of MIBI-SPECT was lowest (71%), whereas exercise ECG, exercise and dobutamine echocardiography had higher specificities (93, 87 and 81%, respectively). Significance, however, was not achieved. Differences in overall accuracy between exercise echocardiography (82%), dobutamine stress echocardiography (80%) and MIBI-SPECT (85%) were not significant. Comparison with accuracy of exercise ECG (62%) was significant (p < 0.05, p < 0.05 and p < 0.01, respectively). In 1-vessel disease, exercise ECG had a lower sensitivity (45%) than exercise and dobutamine echocardiography and MIBI-SPECT (79, 78 and 84%; p < 0.02, p < 0.02 and p < 0.01, respectively). Regarding the 24 patients with false-negative exercise ECG results, 67% had positive exercise echocardiography findings, 71% positive dobutamine echocardiography results and 84% positive technetium-99m MIBI-SPECT results.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Medical Clinic I, RWTH Aachen, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Hoffmann
authors.forename: H
authors.initials: H
authors.lastname: Lethen
authors.forename: E
authors.initials: E
authors.lastname: Kleinhans
authors.forename: M
authors.initials: M
authors.lastname: Weiss
authors.forename: F A
authors.initials: FA
authors.lastname: Flachskampf
authors.forename: P
authors.initials: P
authors.lastname: Hanrath
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000453:epidemiology; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods* / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000379:methods* / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D005080:Exercise Test / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D004280:Dobutamine; D017256:Technetium Tc 99m Sestamibi