<Originals>Detection of myocardial ischemia by stress echocardiography

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The objective of the present study was to assess the diagnostic values of three stress echocardiography tests ; exercise, dobutamine and dipyridamole, for the detection of myocardial ischemia. We performed exercise (supine ergometer), dobutamine (40 μg/kg/min), and dipyridamole (0.84mg/kg over 10min) stress echocardiography testings on 384 patients. Two-dimensional echocardiographic images were digitized and assigned in a quad-screen format for nonbiased interpretation. The image quality score index (IQSI) was the sum of the image quality scores of all views. All patients underwent coronary arteriography. Significant coronary artery disease was defined by ≩75% stenosis of the large coronary arteries. Sensitivity of exercise, dobutamine and dipyridamole echocardiographies was 89%, 83% and 80%, respectively. Specificity was 75%, 81% and 94%, respectively. Diagnostic accuracy was 86%, 83% and 83%, respectively. The sensitivity for one vessel disease tended to be slightly lower with dipyridamole echocardiography. IQSI during stress echocardiography was highest for dipyridamole followed by that of dobutamine and exercise. There were no significant differences in the sensitivity, specificity, and diagnostic accuracy between exercise ^<201>Tl myocardial scintigraphy, and the three stress echocardiography methods. In the present study, exercise, dobutamine and dipyridamole echocardiographies showed high overall diagnostic values despite the different hemodynamic effects. It is concluded that stress echocardiography is extremely useful as a screening test for angina pectoris.
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<Originals>Detection of myocardial ischemia by stress echocardiography

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