[Dobutamine echocardiography for the preoperative evaluation of patients for surgery of the abdominal aorta].
OBJECTIVE
The aim of the study was to assess the value of dobutamine echocardiography (DE) for detecting coronary artery disease (CAD) in patients scheduled for abdominal aortic surgery.


METHODS
Preliminary prospective open study.


METHODS
Thirty-three consecutive patients due to undergo effective abdominal aortic surgery, assessed by preoperative DE.


METHODS
Previous myocardial infarction and atherosclerotic risk factors (RF) were noted. Incremental doses of dobutamine were administered in order to reach 85% of age-predicted maximal heart rate. The occurrence of regional wall motion abnormalities was considered as a positive test. In this case a coronary angiography was performed.


RESULTS
Four patients had a history of angina pectoris. DE was not interpretable in five patients. Among the patients without symptoms, 12 had three RF or more, 12 had less than three RF. In eight patients with a positive test, coronary angiography showed one or more significant main coronary artery stenoses. All patients with angina pectoris had a positive test. None of patients without symptoms and less than three RF had a positive test, one third of patients with no symptomatology but with three RF or more had a positive test (P < 0.05).


CONCLUSIONS
DE has the ability to identify patients with asymptomatic CAD. DE is recommended in patients with high probability of CAD, i.e. with three RF or more.
Ryckwaert
F
F
Service d'anesthésie réanimation B, hôpital Arnaud-de-Villeneuve, Montpellier, France.
Leclercq
F
F
Colson
P
P
D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000601:surgery*; D004280:Dobutamine; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000601:surgery; D011446:Prospective Studies; D012307:Risk Factors; D013566:Sympathomimetics; D014656:Vascular Surgical Procedures / Q000379:methods*
D013566:Sympathomimetics; D004280:Dobutamine