[Echocardiography with dobutamine in hypertensive patients with chest pain].
BACKGROUND
The exercise stress test shows limited diagnostic accuracy for the detection of coronary artery disease in hypertensive patients. Echocardiography with dobutamine is a useful tool in the assessment of coronary artery disease.


OBJECTIVE
Our purpose has been to compare dobutamine stress echocardiography and exercise stress test for diagnosing coronary disease in hypertensive patients.


METHODS
Dobutamine stress echocardiography (administered up to 40 micrograms/kg/min, and atropine when necessary), exercise stress test and coronary arteriography were performed on 74 hypertensive patients with chest pain and no previous history of coronary artery disease.


RESULTS
Forty-eight (65%) patients underwent a diagnostic exercise stress test and 66 (89%) a diagnostic dobutamine stress echocardiography. Coronary artery disease (> or = 70% stenosis in, at least, one major vessel) was demonstrated in 28 (58%) patients who underwent a diagnostic exercise stress test, and in 39 (59%) patients who completed a dobutamine stress echocardiography. Sensitivity for exercise stress test was 82%, and 79% for dobutamine stress echocardiography (p = NS). Specificity was higher for dobutamine stress echocardiography (100% vs 60%; p < 0.005).


CONCLUSIONS
Dobutamine stress echocardiography has high sensitivity and specificity for the detection of coronary artery disease in hypertensive patients. Dobutamine stress echocardiography has higher feasibility and specificity than exercise stress test in this group of patients.
Castillo
J A
JA
Servicio de Cardiología, Hospital Santa María del Rosell, Cartagena, Murcia.
Vilacosta
I
I
San Román
J A
JA
Rollán
M J
MJ
Peral
V
V
de la Torre
M M
MM
Sánchez-Harguindey
L
L
D000368:Aged; D002316:Cardiotonic Agents; D002637:Chest Pain / Q000150:complications / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging*; D004280:Dobutamine; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
D002316:Cardiotonic Agents; D004280:Dobutamine