DOBUTAMINE STRESS ECHOCARDIOGRAPHY FOR PREOPERATIVE CARDIAC RISK STRATIFICATION IN PATIENTS UNDERGOING ORTHOTOPIC LIVER-TRANSPLANTATION

This study attempts to evaluate the efficacy of dobutamine stress echo cardiography for preoperative cardiac risk stratification in patients undergoing orthotopic liver transplantation. Two hundred twenty consec utively submitted patients were evaluated in preparation for orthotopi c liver transplantation. Dobutamine stress echocardiography was perfor med in 80 patients with known or suspected coronary artery disease. Fo llow-up information was available in 40 patients in the form of cardia c catheterization and/or outcome from liver transplantation to validat e the dobutamine stress echo findings. The prevalence of coronary arte ry disease in this cohort was 5% and was closely associated with the p resence of diabetes mellitus. Dobutamine stress echocardiography, when interpreted as abnormal in the presence of wall motion abnormalities only, is associated with a sensitivity, specificity, and positive and negative predictive value of 100%. Dobutamine stress echocardiography is highly efficacious and should be the screening study of choice to d etect coronary artery disease in patients undergoing orthotopic liver transplantation. Copyright (C) 1998 by the American Association for th e Study of Liver Diseases.