title: Prognostic value of dobutamine-atropine stress echocardiography for peri-operative and late cardiac events in patients scheduled for vascular surgery.
abstract: Cardiac events in the peri-operative phase and late after non-cardiac vascular surgery are a major cause of morbidity and mortality. Numerous tests and diagnostic strategies--usually consisting of a combination of analysis of clinical risk factors and additional non-exercise dependent stress testing, such as thallium scintigraphy, or stress echocardiography--have been developed to preoperatively identify patients with increased risk. The tests ideally should identify three subpopulations in a group with a high prevalence of coronary artery disease; (1) low-risk patients who can be referred for surgery without extra cardiac intervention. (2) patients whose peri-operative cardiac risk outweighs the potential benefits of vascular surgery, (3) patients whose risk may be reduced by peri-operative therapeutic interventions. This review will discuss the prognostic value of dobutamine stress echocardiography for risk stratification in patients scheduled for non-cardiac vascular surgery and discuss guidelines for future management.
authors.affiliation: Department of Surgery, University Hospital Rotterdam-Dijkzigt, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Poldermans
authors.forename: R
authors.initials: R
authors.lastname: Rambaldi
authors.forename: P M
authors.initials: PM
authors.lastname: Fioretti
authors.forename: E
authors.initials: E
authors.lastname: Boersma
authors.forename: I R
authors.initials: IR
authors.lastname: Thomson
authors.forename: M R
authors.initials: MR
authors.lastname: van Sambeek
authors.forename: H
authors.initials: H
authors.lastname: van Urk
mesh_terms: D001285:Atropine; D002316:Cardiotonic Agents; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test / Q000379:methods; D006801:Humans; D010276:Parasympatholytics; D011183:Postoperative Complications / Q000175:diagnosis*; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000401:mortality
chemical_list: D002316:Cardiotonic Agents; D010276:Parasympatholytics; D004280:Dobutamine; D001285:Atropine