[Usefulness of transesophageal dobutamine stress echocardiography in the detection of ischemic cardiopathy].
OBJECTIVE
To assess the usefulness of transesophageal dobutamine stress echocardiography (TEDSE), to identify patients with coronary artery disease.


METHODS
Patients referred for TEDSE with coronary angiography were included. Images were digitized in systolic cine-loop at baseline, with low dose-dobutamine (14.4 +/- 5 micrograms/kg/min), with high dose-dobutamine (28.7 +/- 10.5 micrograms/kg/min) and during recovery, and then analyzed by two observers. The left ventricle was divided into 16 segments according to coronary distribution, and the study was considered abnormal if there was a new or worsening of the segmental wall motion abnormality. Quantitative coronary angiographies were independently assessed, and lesions considered significant if they had > or = 70% diameter stenosis.


RESULTS
Sixty eight patients were included. TEDSE sensitivity, specificity, and accuracy were 93%, 89.7%, and 91.1%, respectively. TEDSE correctly detected 7/7 single vessel disease and 20/22 multiple vessel disease patients. Twelve-lead ECG had a sensitivity, specificity, and accuracy of 38.3%, 91.8%, and 74.5% respectively, to detect the same lesions.


CONCLUSIONS
TEDSE is feasible, safe, sensitive, and specific to detect significant coronary lesions. It should be considered in patients with suboptimal acoustic window or poor visualization of endocardial borders.
Azpiri-López
José Ramón
JR
Hospital Christus Muguerza de Monterrey, Calle Hidalgo No. 2525 Pte., Monterrey, N.L., México C.P. 64060. jazpiri@infosel.net.mx
Assad-Morell
José Luis
JL
Hoyos-Pescador
Roxana
R
Loera-Torres
Javier
J
Flores-Coronado
Evangelina
E
D000368:Aged; D000465:Algorithms; D000787:Angina Pectoris / Q000175:diagnosis / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D003627:Data Interpretation, Statistical; D004280:Dobutamine; D017548:Echocardiography, Transesophageal / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013566:Sympathomimetics; D013997:Time Factors
D013566:Sympathomimetics; D004280:Dobutamine