TY - JOUR
T1 - Usefulness of dobutamine stress echocardiography for the prospective identification of the physiologic significance of coronary narrowings of moderate severity in patients undergoing evaluation for percutaneous transluminal coronary angioplasty
AU - Da ́vila-Roma ́n, Victor G.
AU - Wong, Andrew K.
AU - Li, Dean
AU - Shelton, Marc E.
AU - Lasala, John M.
AU - Hopkins, William E.
AU - Feinberg, Micha S.
AU - Pe ́rez, Julio E.
N1 - Funding Information:
From the Cardiovascular Division, Washington University School of Medicine, St. louis, Missouri. This work was supported in part during the tenure of a Minority Scientist Development Award from the American Heart Association, Dallas, Texas, and by the National Institutes of Health HL-17646 (SCOR in Coronary and Vascular Diseases) Minority Investigator Research Grant (MIRS), Bethesda, Maryland, both to Dr. D&ila-Rom6n. Manuscript received January 16, 1995; revised manuscript received and accepted May 22, 1995. Address for reprints: Victor G. D&la-Rombn, MD, Cardiovascular Division, Box 8086, Washington University, 660 South Euclid Avenue, St. louis, Missouri 631 10.
PY - 1995/8/1
Y1 - 1995/8/1
N2 - Dobutomine stress echocardiography (DSE) was performed after coronary angiography to evaluate the need to perform percutaneous transluminal coronary angioplasty (PTCA) for 46 stenoses of moderate severity (50% to 80%) in 46 patients. Patients were divided into 2 groups according to the DSE results in the distribution of the coronary artery with the lesion of moderate severity: group I (n = 32) were those without inducible myocardial ischemia; PTCA was not performed. Group II (n = 14) were those who exhibited myocardial ischemia; PTCA was performed in 12. The 2 groups were comparable in terms of clinical characteristics. Follow-up DSE was performed ≤48 hours after PTCA, at 3 months, and 6 to 12 months after the first DSE. In group I at 3 months, DSE results were still negative in the distribution of the vessel with the moderately severe lesion in 24 patients; only 1 patient had a positive result, and 8 patients who refused DSE remained clinically stable. At 6 to 12 months (mean 7 ± 2), 26 patients had negative study results; 3 patients who refused follow-up DSE remained clinically stable. In group II, 12 of 14 patients with inducible ischemia on the initial DSE underwent PTCA. Early follow-up DSE (≤48 hours) was negative in 7, and 4 had persistent inducible wall motion abnormalities in the myocardium subtended by the coronary artery in which the PTCA had been performed; 1 study was not performed. At 3-month follow-up, 1 patient who had an early DSE study positive for ischemia had no demonstrable ischemia, and 3 patients continued to have myocardial ischemia in the myocardium subtended by the coronary artery in which the PTCA was performed. At the 6- to 12-month follow-up (mean 7 ± 1), 8 patients had DSE studies that remained negative for inducible ischemia. Thus, DSE is an appropriate test to assess the physiologic significance of coronary artery lesions of moderate severity in patients being evaluated for PTCA.
AB - Dobutomine stress echocardiography (DSE) was performed after coronary angiography to evaluate the need to perform percutaneous transluminal coronary angioplasty (PTCA) for 46 stenoses of moderate severity (50% to 80%) in 46 patients. Patients were divided into 2 groups according to the DSE results in the distribution of the coronary artery with the lesion of moderate severity: group I (n = 32) were those without inducible myocardial ischemia; PTCA was not performed. Group II (n = 14) were those who exhibited myocardial ischemia; PTCA was performed in 12. The 2 groups were comparable in terms of clinical characteristics. Follow-up DSE was performed ≤48 hours after PTCA, at 3 months, and 6 to 12 months after the first DSE. In group I at 3 months, DSE results were still negative in the distribution of the vessel with the moderately severe lesion in 24 patients; only 1 patient had a positive result, and 8 patients who refused DSE remained clinically stable. At 6 to 12 months (mean 7 ± 2), 26 patients had negative study results; 3 patients who refused follow-up DSE remained clinically stable. In group II, 12 of 14 patients with inducible ischemia on the initial DSE underwent PTCA. Early follow-up DSE (≤48 hours) was negative in 7, and 4 had persistent inducible wall motion abnormalities in the myocardium subtended by the coronary artery in which the PTCA had been performed; 1 study was not performed. At 3-month follow-up, 1 patient who had an early DSE study positive for ischemia had no demonstrable ischemia, and 3 patients continued to have myocardial ischemia in the myocardium subtended by the coronary artery in which the PTCA was performed. At the 6- to 12-month follow-up (mean 7 ± 1), 8 patients had DSE studies that remained negative for inducible ischemia. Thus, DSE is an appropriate test to assess the physiologic significance of coronary artery lesions of moderate severity in patients being evaluated for PTCA.
UR - http://www.scopus.com/inward/record.url?scp=0029118970&partnerID=8YFLogxK
U2 - 10.1016/S0002-9149(99)80074-5
DO - 10.1016/S0002-9149(99)80074-5
M3 - Article
C2 - 7618617
AN - SCOPUS:0029118970
SN - 0002-9149
VL - 76
SP - 245
EP - 249
JO - The American journal of cardiology
JF - The American journal of cardiology
IS - 4
ER -