Dobutamine stress echocardiography in patients undergoing liver transplantation evaluation.
BACKGROUND
Coronary artery disease has an important impact on perioperative morbidity and mortality in patients undergoing liver transplantation. To assess the role of dobutamine stress echocardiography (DSE) in these patients, DSE was included in the preoperative evaluation.


METHODS
Patients under consideration for liver transplantation underwent detailed clinical history, electrocardiography, and echocardiography. Patients with documented coronary disease or symptoms of myocardial ischemia underwent angiography. The remaining patients with cardiac risk factors, atypical chest pain, or age > or = 60 years underwent DSE.


RESULTS
These 121 patients (77 men and 44 women) ranged in age from 34 to 73 years (mean 53). Among the 61 patients who underwent liver transplantation, DSE was normal in 25, nondiagnostic in 34 because of inadequate heart rate response, and abnormal in two patients. Major perioperative events occurred in eight patients, all with normal or nondiagnostic DSE studies (negative predictive value 86%).


CONCLUSIONS
In patients with low to moderate risk of cardiac disease, DSE performed as part of an evaluation for liver transplantation is a poor predictor of major perioperative events.
Williams
K
K
Department of Internal Medicine, University of Florida College of Medicine, Gainesville 32610-0277, USA.
Lewis
J F
JF
Davis
G
G
Geiser
E A
EA
D000328:Adult; D000368:Aged; D002316:Cardiotonic Agents / Q000009:adverse effects; D002637:Chest Pain / Q000000981:diagnostic imaging; D004280:Dobutamine / Q000009:adverse effects; D004452:Echocardiography; D005080:Exercise Test / Q000009:adverse effects; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors
D002316:Cardiotonic Agents; D004280:Dobutamine