OBJECTIVES: This study was designed to establish the appropriate diagnostic criteria for positive dobutamine electrocardiographic (ECG) stress test results and to compare their accuracy with those of dobutamine two-dimensional echocardiography and perfusion scintigraphy. BACKGROUND: Conventional criteria for positive findings on ECG exercise testing may not be appropriate for use with dobutamine ECG stress testing. METHODS: One hundred twenty-nine consecutive patients with an interpretable ECG and without previous myocardial infarction were prospectively studied at the time of coronary arteriography. All completed a standard dobutamine protocol (5 to 40 micrograms/kg body weight per min in 3-min dose increments) without side effects. Significant coronary artery disease, defined as > 50% lumen diameter stenosis of a major epicardial coronary artery on coronary angiography, was present in 83 patients. Empiric receiver operating curves were generated for various ECG criteria derived from computer-averaged signals. RESULTS: The best ECG criterion, with a sensitivity of 42% and a specificity of 83%, was an ST segment shift, relative to baseline, of 0.5 mm 80 ms after the J point. The sensitivity of this criterion was greater than that of the conventional criterion of 1-mm ST segment depression 60 (23%) or 80 (18%) ms after the J point, was comparable to that of chest pain occurring during the test (44%, p = NS) but remained inferior to the sensitivities of technetium-99m methoxyl isobutyl isonitrile (mibi) perfusion (76%) or stress echocardiography (76%, p < 0.001, for both). The specificity of this criterion was not significantly different from that of technetium-99m mibi perfusion tomography (65%) or stress echocardiography (89%) but was superior to that of chest pain (59%, p < 0.025). CONCLUSIONS: We conclude that this new criterion for dobutamine electrocardiography is specific but that an imaging technique is still required to accurately predict coronary artery disease.
OBJECTIVES: This study was designed to establish the appropriate diagnostic criteria for positive dobutamine electrocardiographic (ECG) stress test results and to compare their accuracy with those of dobutamine two-dimensional echocardiography and perfusion scintigraphy. BACKGROUND: Conventional criteria for positive findings on ECG exercise testing may not be appropriate for use with dobutamine ECG stress testing. METHODS: One hundred twenty-nine consecutive patients with an interpretable ECG and without previous myocardial infarction were prospectively studied at the time of coronary arteriography. All completed a standard dobutamine protocol (5 to 40 micrograms/kg body weight per min in 3-min dose increments) without side effects. Significant coronary artery disease, defined as > 50% lumen diameter stenosis of a major epicardial coronary artery on coronary angiography, was present in 83 patients. Empiric receiver operating curves were generated for various ECG criteria derived from computer-averaged signals. RESULTS: The best ECG criterion, with a sensitivity of 42% and a specificity of 83%, was an ST segment shift, relative to baseline, of 0.5 mm 80 ms after the J point. The sensitivity of this criterion was greater than that of the conventional criterion of 1-mm ST segment depression 60 (23%) or 80 (18%) ms after the J point, was comparable to that of chest pain occurring during the test (44%, p = NS) but remained inferior to the sensitivities of technetium-99m methoxyl isobutyl isonitrile (mibi) perfusion (76%) or stress echocardiography (76%, p < 0.001, for both). The specificity of this criterion was not significantly different from that of technetium-99m mibi perfusion tomography (65%) or stress echocardiography (89%) but was superior to that of chest pain (59%, p < 0.025). CONCLUSIONS: We conclude that this new criterion for dobutamine electrocardiography is specific but that an imaging technique is still required to accurately predict coronary artery disease.
Authors: Yoshinori Noguchi; Shizuko Nagata-Kobayashi; James E Stahl; John B Wong Journal: Int J Cardiovasc Imaging Date: 2005 Apr-Jun Impact factor: 2.357
Authors: G M Santoro; R Sciagrà; P Buonamici; N Consoli; V Mazzoni; F Zerauschek; G Bisi; P F Fazzini Journal: J Nucl Cardiol Date: 1998 Jan-Feb Impact factor: 5.952
Authors: V De Bello; C R Bellina; N Molea; L Talarico; G Boni; E Magagnini; F Matteucci; D Giorgi; E Lazzeri; A Bertini; M F Romano; R Bianchi; C Giusti Journal: Int J Card Imaging Date: 1996-09
Authors: V Di Bello; C R Bellina; E Gori; N Molea; L Talarico; G Boni; E Magagnini; F Matteucci; D Giorgi; E Lazzeri; A Bertini; M F Romano; R Bianchi; C Giusti Journal: J Nucl Cardiol Date: 1996 May-Jun Impact factor: 5.952
Authors: G Dori; Y Denekamp; S Fishman; A Rosenthal; V Frajewicki; B S Lewis; H Bitterman Journal: Med Biol Eng Comput Date: 2004-05 Impact factor: 2.602
Authors: A Elhendy; M L Geleijnse; J R Roelandt; J H Cornel; R T van Domburg; A E Reijs; P R Nierop; P M Fioretti Journal: Eur J Nucl Med Date: 1996-10