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KMID : 0390619930010010001
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Journal of Cardiovascular Ultrasound
1993 Volume.1 No. 1 p.1 ~ p.15
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Usefulness of Stress Echocardiography in the Diagnosis of Coronary Artery Disease :
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최철준
강홍선/조정휘/김권삼/김명식/송정상/배종화
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Abstract
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Background :
@EN Exercise electrocardiography (ECG) has widely accepted as a simple screening test for coronary artery disease (CAD). But this technique also has well known limitations.
Recently numerous methods were introduced to overcome that limitations. The technical improvement of echocardiography (Echo) and the development of methods of ventricular wall motion analysis made stress Echo useful for the detection of CAD
Exercise
stress echocardiography (ESE) and pharmacologic stress echocardiography (PSE) can be performed instead of exercise ECG We evaluate the value and reliability of ESE and PSE for the detection of CAD
@ES Method :
@EN We studied 198 patients who complained chest pain and underwent coronary arteriography by stress echocardiography Among them, 131cases (80 males. 51 females ; average age 53 years) were assigned to ESE 33 cases (21 males, 12 females ; average
56
years) to dipyridamole PSE and 34 males, 11 females ; average age 54 years) to dobutamine PSE
@ES Results :
@EN These results were compared with coronary angicgraphic results and exercise stress ECG
1) The sensitivity of exercise stress echocardiography was significantly higher than the sensitivity of exercise ECG (88.0% vs 60.0%, p,0.05) There was no significant difference in the specificity of two tests (87.5% vs 73.2%).
2) Exercise stress echocardiography was significantly more sensitive than exercise ECG in patients with single vessel disease( 84.6% vs 46.2%, p<0.05) and two vessel disease (90.9% vs 66.7%, p<0.05). there was no significant difference in three
vessel
disease.
3) Dipyridamole PSE revealed 75% sensitivity and 78% specificity and no serious side effects were observed
4) Dobutamine PSE revealed 86% sensitivity and 85% specificity Some arrhythmias of mild degree were detected during the test but no hemodynamic changes were observed.
@ES Conclusion :
@EN Exercise stress echocardiography is more sensitive test than exercise ECG as a screening test for the detection of CAD PSE was also useful diagnostic method with reliable sensitivity and specificity and without serious side effects. Therefore
these
ESE and PSE are a useful noninvasive methods for the detection and evaluation. of CAD.
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KEYWORD
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