THE VALUE OF DOBUTAMINE STRESS ECHOCARDIOGRAPHY FOR THE DETECTION OF CORONARY-ARTERY DISEASE IN WOMEN

To determine whether there were any gender-based differences in the de tection of coronary artery disease by dobutamine stress echocardiograp hy, we examined 288 patients (187 men and 101 women) who underwent cor onary angiography within 8 weeks of dobutamine stress testing. Abnorma l test results were indicated by left ventricular wall motion abnormal ities at rest, which did not improve or worsen, or inducible wall moti on abnormalities in two or more segments with dobutamine. Overall, dob utamine stress echocardiography showed a high sensitivity, specificity , and accuracy in both men and women: 85%, 96%, and 88% and 90%, 79%, and 86%, respectively. The sensitivity in detecting significant corona ry artery disease in our population was not influenced by gender. Howe ver, the sensitivity of the test was influenced by the extent and loca tion of coronary disease and the pattern of left ventricular hypertrop hy. The sensitivity was 80% in patients with single-vessel disease, wh ereas the sensitivity was 91% in patients with multivessel disease. In addition, patients with single-vessel disease had lower sensitivity w hen the abnormality was located in the left circumflex coronary artery territory (59% versus 86% in the left anterior descending and right c oronary territories). Our data indicated that there is no gender-based difference in the sensitivity and specificity of dobutamine stress ec hocardiography in detecting coronary artery disease and that the limit ations of the test should be attributed to the extent and location of coronary disease.