DIAGNOSTIC-VALUE OF DOBUTAMINE ECHOCARDIO GRAPHY IN EVERYDAY PRACTICE

In order to evaluate the place of dobutamine echocardiography in every day practice, this test and a stress ECG were performed ih 34 patients referred for diagnostic or assessment coronary angiography. Dobutamin e, administered in 3-minute stages from 5 to 30 mu g/kg/min, was well tolerated. The anti-ischaemic treatment was continued in 26 patients b efore dobutamine echocardiography and in 15 patients before the stress ECG. The electrocardiographic, echocardiographic and angiographic doc uments were each analysed by 2 independent observers. Dobutamine echoc ardiography was considered to be positive in the presence of the devel opment of a new abnormality of segmental kinetics or when abnormality of segmental kinetics was identified outside of the territory of infar ction. With reference to coronary angiography, the sensitivity of stre ss ECG and dobutamine echocardiography was 46% and 42%, respectively, and the specificity was 75% and 88%, respectively ; the sensitivity of each test was low, probably because of fake tests. The combination of the two tests improved the sensitivity (69%) without altering the spe cificity (75%). Dobutamine echocardiography could usefully complete a negative stress ICG whenever a false-negative result is suspected to a voir wrongly reassuring some patients and to allow appropriate managem ent.