Functional assessment of coronary grafts on dobutamine pharmacological stress echocardiogram.
OBJECTIVE
To verify the sensitivity, specificity and diagnostic accuracy of dobutamine stress echocardiogram (DSE) when assessing the functional status of coronary grafts: sufficient (SUF) or insufficient (INS).


METHODS
We carried out a prospective, observational study which included 25 patients submitted to coronary artery bypass grafting (CABG). The DSE and the coronary angiography were performed before the CABG and three months after the CABG. The left ventricle was divided into three territories per patient according to the three major coronary arterie: the anterior descending (AD), the circumflex (CX) and the right coronary (RC). Of the 75 possible territories, 54 were revascularized: 25 were specific to the AD artery and 29 of the CX/RC arteries. INS means luminal obstruction or occlusion greater than or equal to 50%.


RESULTS
In 14 (26%) of the 54 revascularized territories the grafts were INS. The DSE detected ischemia in 16 (28%) territories; 10 of which had INS grafts. The DSE detected ischemia in 6 (15%) of the 40 territories whose grafts were SUF. Therefore, the DSE had a sensitivity of 71.4%, specificity of 85% and diagnostic accuracy of 81.4%.


CONCLUSIONS
The DSE is a diagnostic method with high specificity and diagnostic accuracy, and good sensitivity for the functional assessment of coronary grafts.
Pittella
Felipe José Monassa
FJ
Instituto Nacional de Cardiologia Laranjeiras, Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil. fjmpitella@superig.com.br
da Cunha
Ademir Batista
AB
Romeu Filho
Luiz José Martins
LJ
Labrunie
Marta Moraes
MM
Weitzel
Luis Henrique
LH
Melhado
Júlio César
JC
da Rocha
Antônio Sergio Cordeiro
AS
D000328:Adult; D000368:Aged; D002316:Cardiotonic Agents; D001026:Coronary Artery Bypass / Q000009:adverse effects; D004280:Dobutamine; D025401:Echocardiography, Stress / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014654:Vascular Patency
D002316:Cardiotonic Agents; D004280:Dobutamine