Value of negative dobutamine stress echocardiography in predicting long-term cardiac events

To determine the value of negative dobutamine stress echocardiography (DSE) results in predicting subsequent long-term cardiac event rates, we retrosp ectively reviewed all dobutamine stress echocardiograms performed at our in stitution over a 3-year period (1992-1994). Follow-up was accomplished thro ugh the completion of a detailed questionnaire compiled fr om data obtained through chart review and direct telephone contact. information regarding d eath also was determined by referencing patient data with mortality data av ailable on the World Wide Web. Event rates were determined for hard (myocar dial infarction [MI] or cardiac death) and soft (hospitalization for angina and/or congestive heart failure, coronary angioplasty, or coronary bypass surgery) cardiac events occurring after the negative DSE results for up to 7 years after the test. Negative test results were defined as those showing no new or worsening wall motion abnormalities after either a normal restin g echocardiogram (normal-negative [NN]) or an abnormal segmental resting ec hocardiogram (fixed-negative [FN]). Results: Of the 346 interpretable tests, 224 were negative for inducible wa ll motion abnormalities, with 171 NN and 53 FN. in the NN group, the MI rat e was 1.5% per patient/year, and the mortality rate was 0.13% per patient/y ear. In the FN group, the MI rate was 0.7% per patient/year, and the mortal ity rate was 0% per patient/year. Conclusions: DSE results in both NN and FN groups predict a very low subseq uent hard event rate and mortality for up to 5 years after the test.