title: [Stress echocardiography in the pre-operative evaluation of patients undergoing major vascular surgery. Are results comparable with dypiridamole versus dobutamine stress echo?].
abstract: BACKGROUND
  [corrected] Perioperative cardiovascular complications are an important cause of post-surgical morbility and mortality in patients undergoing major vascular surgery. Dobutamine Stress Echo is considered one of the methods of choice in the detection of coronary artery disease in this subgroup of patients.
  
  
  OBJECTIVE
  . Our aim was to analyze if dipyridamole stress echocardiography could be used as an alternative to Dobutamine Stress Echo in the perioperative evaluation of patients in need of major vascular surgery.
  
  
  METHODS
  The result of consecutives dypiridamole and dobutamine stress exams prior to vascular surgery were reviewed. We analyzed if those patients with a positive stress echo presented a higher number of cardiac events during and after surgery than those with negative stress echo. The negative and positive predictive values were calculated for both techniques.
  
  
  RESULTS
  133 stress exams were analysed: 39 with dobutamine and 94 with dipyridamole. Of the 39 dobutamine studies 2 were positive, 29 negatives and 8 non conclusive. Of the 94 dypiridamole studies 13 were positive and 81 negatives. None of the patients with a positive dobutamine echo underwent surgery. The negative predictive value for dobutamine echo was 96.5%, quite similar to that of dypiridamole stress echo (97.5%).
  
  
  CONCLUSIONS
  Dipyridamole stress echocardiography is a valid alternative to dobutamine echocardiography in the pre-surgical evaluation of patients undergoing major vascular surgery.
authors.affiliation: Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain. jlzamorano@jet.es
authors.forename: José
authors.initials: J
authors.lastname: Zamorano
authors.forename: Amelia
authors.initials: A
authors.lastname: Duque
authors.forename: Mario
authors.initials: M
authors.lastname: Baquero
authors.forename: Raúl
authors.initials: R
authors.lastname: Moreno
authors.forename: Carlos
authors.initials: C
authors.lastname: Almería
authors.forename: José Luis
authors.initials: JL
authors.lastname: Rodrigo
authors.forename: Ignacio
authors.initials: I
authors.lastname: Díez
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Rial
authors.forename: Javier
authors.initials: J
authors.lastname: Serrano
authors.forename: Luis
authors.initials: L
authors.lastname: Sánchez-Harguindey
mesh_terms: D004176:Dipyridamole; D004280:Dobutamine; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D014656:Vascular Surgical Procedures
chemical_list: D004280:Dobutamine; D004176:Dipyridamole