DOBUTAMINE STRESS ECHOCARDIOGRAPHY - FALSE-POSITIVE SCANS IN PROTEINURIC PATIENTS WITH TYPE-1 DIABETES-MELLITUS AT HIGH-RISK OF ISCHEMIC-HEART-DISEASE

Patients with Type 1 diabetes mellitus have an increased risk of ischa emic heart disease (IHD). When diabetes is complicated by nephropathy this risk is further increased and asymptomatic IHD is common. New tec hniques for non-invasive cardiac evaluation are now available and one of these, Dobutamine Stress Echocardiography (DSE), was studied in sub jects with Type 1 DM and nephropathy who had no evidence of IHD. DSE w as performed on 18 subjects (13 male, 5 female; mean age 37.8 +/- 3.4 years), diabetes duration 23.7 +/- 1.2 years and nephropathy diagnosed for 10.9 +/- 1.3 years. There were 7 (38 %) positive scans-suggesting asymptomatic IHD; 16.7 % of subjects studied had a significant arrhyt hmia. Coronary angiography was performed in 6 of the 7 subjects with p ositive DSEs and was positive in only 2. These results suggest that DS E has a high rate of false positive results in Type 1 DM patients suff ering from nephropathy and may limit its usefulness in these subjects. (C) 1998 John Wiley & Sons, Ltd.