Dobutamine stress radionuclide ventriculography for the detection of coronary artery disease

GÜNALP B., Uyan C., Dokumaci B., Özgüven M., Vardareli E., Öztürk E., ...Daha Fazla

Nuclear Medicine Communications, cilt.14, sa.6, ss.471-478, 1993 (Scopus)

Özet

Thirty patients were prospectively studied to assess the value of radionuclide ventriculography (RNV) during step-wise dobutamine infusion for the detection of coronary artery disease (CAD). Radionuclide ventriculography was performed under basal conditions and during dobutamine infusion at each 10 µg kg-1min-1dose increment from 10 to a maximum of 40 µg kg-1min-1. The test response was considered positive if the ejection fraction (EF) decreased by more than 5% or if segmental contraction abnormalities developed. Dobutamine stress testing was well tolerated, no complications and no significant arrhythmia were observed. In nine of 11 patients without CAD, EF increased more than 5% of the rest value and the left ventricular wall motion was normal in 10 of them during dobutamine infusion (specificity 91%). In 18 of 19 patients with CAD, new wall motion abnormalities (WMA) were identified in segments corresponding to the arterial lesions diagnosed by angiography (sensitivity 94%). Ejection fraction response was significantly different in normal subjects and in patients with CAD: 11 ± 5.9% versus 1. 9 ± 9.5% (P < 0.01). However, abnormal EF response was found in seven of 19 CAD patients and development of new WMA was found to be a more sensitive and specific parameter than EF response for dobutamine RNV. It is concluded that dobutamine RNV is an accurate, widely available and cost- effective test for detecting CAD, especially in patients unable to exercise. © 1993 Chapman and Hall Ltd.