Dobutamine stress echocardiography in the detection of coronary artery disease in a clinical practice setting

Terence G. Hennessy, Mary B. Codd, Conor McCarthy, Garvin Kane, Hugh A. McCann, Declan D. Sugrue

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

In this prospective study, patients referred for coronary angiography for detection of disease underwent dobutamine stress echocardiography to define its value in a clinical practice setting. Results: Of 219 patients studied, 170 (78%) had significant coronary artery disease. The overall sensitivity and specificity of dobutamine stress echocardiography for coronary artery disease were 82 and 65%, respectively. The sensitivity was 88% for detection of triple-vessel disease, 83% for double-vessel disease, and 74% for single-vessel disease. Positive and negative predictive values for coronary artery disease were 89 and 51%, respectively. Dobutamine stress echocardiography correctly identified only 72 of 138 patients with significant stenosis of the left anterior descending coronary artery. In 219 patients, 345 of 657 major epicardial vessels had significant disease. Dobutamine stress echocardiography could only correctly identify the vessel involved in 188. Triple-vessel disease was present in 65 patients. Dobutamine stress echocardiography correctly categorised 18% (n = 12) of these. The remainder were incorrectly classified as having double-vessel disease or single-vessel disease (n=45), or no disease at all (n=8). Conclusion: Dobutamine stress echocardiography performs well. However, lower specificity may lead to unwarranted referrals for coronary angiography, and the low NPV give false reassurance as to the absence of disease.

Original languageEnglish (US)
Pages (from-to)55-62
Number of pages8
JournalInternational Journal of Cardiology
Volume62
Issue number1
DOIs
StatePublished - Oct 31 1997

Keywords

  • Accuracy
  • Coronary artery disease
  • Dobutamine stress echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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