Role of dobutamine stress echocardiography in predicting outcome in 860 patients with known or suspected coronary artery disease.
BACKGROUND
Increasingly, dobutamine stress echocardiography has been used for detection of coronary artery disease. Less information exists regarding the incremental prognostic value of the test, including semiquantitative wall scoring, compared with clinical and rest echocardiographic variables.


RESULTS
Follow-up information was obtained from 860 patients who underwent dobutamine stress echocardiography over a 2-year period. To determine the value of dobutamine stress echocardiography in predicting cardiac events, including cardiac death and myocardial infarction, clinical and rest and stress echocardiographic data were considered in a stepwise Cox multivariate regression model. During follow-up of up to 52 months, 72 patients underwent coronary revascularization before any cardiac event and were censored. Eighty-six patients had cardiac events, including nonfatal myocardial infarction in 36 and cardiac death in 50. In a multivariate model, a history of congestive heart failure, the percentage of abnormal segments at peak stress, and an abnormal left ventricular end-systolic volume response to stress were independent predictors of cardiac events. The model that best predicted subsequent cardiac events included clinical and stress echocardiographic data.


CONCLUSIONS
Dobutamine stress echocardiography with semiquantitative segmental wall scoring provides important incremental information in predicting subsequent cardiac events.
Chuah
S C
SC
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA.
Pellikka
P A
PA
Roger
V L
VL
McCully
R B
RB
Seward
J B
JB
D000368:Aged; D000369:Aged, 80 and over; D002306:Cardiac Volume; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D004280:Dobutamine; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000628:therapy; D015425:Myocardial Reperfusion; D015588:Observer Variation; D011237:Predictive Value of Tests; D011379:Prognosis; D013312:Stress, Physiological / Q000000981:diagnostic imaging; D013566:Sympathomimetics; D016896:Treatment Outcome
D013566:Sympathomimetics; D004280:Dobutamine