Assessment of the coronary artery disease and systolic dysfunction in hypertensive patients with the dobutamine-atropine stress echocardiography: Effect of the left ventricular hypertrophy
Journal
Cardiology
Journal Volume
89
Journal Issue
1
Pages
52-58
Date Issued
1997
Author(s)
MING-FONG CHEN
Liau, Chiau-Suong
Lee, Yuang-Teh
Abstract
This study was performed to evaluate whether left ventricular hypertrophy (LVH) can influence the diagnostic accuracy of coronary artery disease (CAD) using the dobutamine stress echocardiography (DSE) in hypertensive patients. In addition to the detection of CAD, the relationship between systolic dysfunction and the quantitation wall motion scoring system of DSE was studied also. DSE was performed in 101 patients. There were 45 (45%) patients with a history of acute myocardial infarction. Twenty-eight patients (28%) had electrocardiographic LVH and 59 patients (58%) had echocardiographic LVH. A total of 74 patients (73%) had angiographically documented CAD defined as ? 50% diameter stenosis. For the 56 patients without history of myocardial infarction, the diagnostic sensitivity, specificity, and accuracy in detecting CAD were not influenced by LVH defined by either electrocardiography or echocardiography. For the total patients, the diagnostic sensitivity, specificity, and accuracy in detecting multivessel disease were also not influenced by LVH defined by either method. The resting global wall motion score was correlated well with the left ventricular ejection fraction in patients with and without LVH (r = -0.70, p < 0.001 vs. r = -0.70, p < 0.001). When using the resting wall motion score of 24 as a cutoff value, the diagnostic sensitivity, specificity, and accuracy of systolic dysfunction (defined by left ventricular ejection fraction < 40%) were 79, 86 and 85%, respectively. In conclusion, the diagnostic accuracy of CAD using the DSE was not affected by LVH in hypertensive patients. In addition to detection of coronary artery disease, the resting wall motion score of DSE was able to detect systolic dysfunction in patients with and without LVH.
SDGs
Other Subjects
atropine; dobutamine; cardiotonic agent; diagnostic agent; dobutamine; acute heart infarction; adult; aged; article; coronary artery disease; coronary artery obstruction; diagnostic accuracy; diagnostic value; echocardiography; exercise electrocardiography; female; heart left ventricle ejection fraction; heart left ventricle hypertrophy; human; hypertension; intravenous drug administration; major clinical study; male; priority journal; scoring system; coronary artery disease; echography; exercise test; heart left ventricle function; heart stroke volume; hypertension; middle aged; pathophysiology; roc curve; sensitivity and specificity; systole; Aged; Atropine; Cardiotonic Agents; Coronary Disease; Dobutamine; Exercise Test; Female; Humans; Hypertension; Hypertrophy, Left Ventricular; Male; Middle Aged; ROC Curve; Sensitivity and Specificity; Stroke Volume; Systole; Ventricular Dysfunction, Left
Publisher
S. Karger AG
Type
journal article