title: Comparison of squatting stress echocardiography and dobutamine stress echocardiography for the diagnosis of coronary artery disease.
abstract: BACKGROUND
  Dobutamine stress echocardiography (DSE) is commonly used for the diagnosis for coronary artery disease (CAD). We previously demonstrated that squatting induces wall motion abnormalities (WMA) in areas subtended by stenotic coronary arteries.
  
  
  OBJECTIVE
  This study was designed to test the hypothesis that dobutamine and squatting stress echocardiography are equally useful for the diagnosis of CAD.
  
  
  METHODS
  We studied 39 patients who were scheduled to have coronary angiography for the evaluation of chest pain. Each patient had squatting stress echocardiography followed by DSE. For squatting stress echocardiography the echocardiogram in standard views was recorded in the standing position. The procedure was repeated during squatting for 2 minutes. Dobutamine echocardiography was performed using standard protocol. The squatting and dobutamine stress echocardiograms were interpreted by an observer blinded to the results of coronary angiography.
  
  
  RESULTS
  During squatting, new or worsening WMA developed in 20 patients. Six patients developed WMA in the left anterior descending artery territory, three in circumflex territory, three in the right coronary artery territory, and eight in multiple coronary territories. The sensitivity, specificity, and accuracy of squatting echocardiography for diagnosis of CAD were 95%, 94%, and 94%, respectively. For DSE, the sensitivity, specificity, and accuracy for the diagnosis of CAD were 85%, 94%, and 90%, respectively. There was no significant difference between squatting and dobutamine stress echocardiography for the diagnosis of CAD (P = 0.702).
  
  
  CONCLUSIONS
  These data indicate that squatting and dobutamine echocardiography are equally useful in the diagnosis of CAD. In selected patients, squatting echocardiography may be used in place of dobutamine echocardiography for the diagnosis of CAD.
authors.affiliation: Division of Cardiology, UC Irvine School of Medicine, Irvine, California, USA. echodop@gmail.com
authors.forename: P Anthony N
authors.initials: PA
authors.lastname: Chandraratna
authors.forename: Vadim A
authors.initials: VA
authors.lastname: Kuznetsov
authors.forename: Dilbahar S
authors.initials: DS
authors.lastname: Mohar
authors.forename: Peter F
authors.initials: PF
authors.lastname: Sidarous
authors.forename: Joseph
authors.initials: J
authors.lastname: Scheutz
authors.forename: Dmitry V
authors.initials: DV
authors.lastname: Krinochkin
authors.forename: Yulia A
authors.initials: YA
authors.lastname: Pak
authors.forename: Prabhsimran
authors.initials: P
authors.lastname: Mohar
authors.forename: Udeni
authors.initials: U
authors.lastname: Arawgoda
mesh_terms: D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D004280:Dobutamine; D025401:Echocardiography, Stress / Q000379:methods*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D004280:Dobutamine