F Ryckwaert1, F Leclercq, P Colson. 1. Service d'anesthésie réanimation B, hôpital Arnaud-de-Villeneuve, Montpellier, France.
Abstract
OBJECTIVE: The aim of the study was to assess the value of dobutamine echocardiography (DE) for detecting coronary artery disease (CAD) in patients scheduled for abdominal aortic surgery. STUDY DESIGN: Preliminary prospective open study. PATIENTS: Thirty-three consecutive patients due to undergo effective abdominal aortic surgery, assessed by preoperative DE. METHODS: Previous myocardial infarction and atherosclerotic risk factors (RF) were noted. Incremental doses of dobutamine were administered in order to reach 85% of age-predicted maximal heart rate. The occurrence of regional wall motion abnormalities was considered as a positive test. In this case a coronary angiography was performed. RESULTS: Four patients had a history of angina pectoris. DE was not interpretable in five patients. Among the patients without symptoms, 12 had three RF or more, 12 had less than three RF. In eight patients with a positive test, coronary angiography showed one or more significant main coronary artery stenoses. All patients with angina pectoris had a positive test. None of patients without symptoms and less than three RF had a positive test, one third of patients with no symptomatology but with three RF or more had a positive test (P < 0.05). CONCLUSION: DE has the ability to identify patients with asymptomatic CAD. DE is recommended in patients with high probability of CAD, i.e. with three RF or more.
OBJECTIVE: The aim of the study was to assess the value of dobutamine echocardiography (DE) for detecting coronary artery disease (CAD) in patients scheduled for abdominal aortic surgery. STUDY DESIGN: Preliminary prospective open study. PATIENTS: Thirty-three consecutive patients due to undergo effective abdominal aortic surgery, assessed by preoperative DE. METHODS: Previous myocardial infarction and atherosclerotic risk factors (RF) were noted. Incremental doses of dobutamine were administered in order to reach 85% of age-predicted maximal heart rate. The occurrence of regional wall motion abnormalities was considered as a positive test. In this case a coronary angiography was performed. RESULTS: Four patients had a history of angina pectoris. DE was not interpretable in five patients. Among the patients without symptoms, 12 had three RF or more, 12 had less than three RF. In eight patients with a positive test, coronary angiography showed one or more significant main coronary artery stenoses. All patients with angina pectoris had a positive test. None of patients without symptoms and less than three RF had a positive test, one third of patients with no symptomatology but with three RF or more had a positive test (P < 0.05). CONCLUSION: DE has the ability to identify patients with asymptomatic CAD. DE is recommended in patients with high probability of CAD, i.e. with three RF or more.