DETECTION OF CORONARY-ARTERY DISEASE USING DOBUTAMINE STRESS ECHOCARDIOGRAPHY IN PATIENTS WITH AN ABNORMAL RESTING ELECTROCARDIOGRAPH

Purpose. We assessed the value of dobutamine stress echocardiography f or the detection of coronary artery disease in patients with chest pai n and an abnormal resting electrocardiograph (ECG). Methods. Dobutamin e stress echocardiography was performed in a standard fashion. Signifi cant coronary artery disease was defined as a >50% luminal diameter st enosis on coronary angiography. Results. The sensitivity, specificity, positive and negative predictive value of dobutamine stress echocardi ography for the detection of coronary artery disease in 218 patients w ere 89, 50, 95 and 32%, respectively. The sensitivity for detection of multi-, double- and single vessel disease were 97, 82 and 81%, respec tively. The sensitivity for the detection of coronary artery disease i n a subgroup of 69 patients by treadmill exercise testing was 37%. Con clusion. Dobutamine stress echocardiography is better than exercise EC G for the detection of significant coronary artery disease. The negati ve predictive value of dobutamine stress echocardiography in this pati ent group is low. (C) 1998 Elsevier Science Ireland Ltd.