Comparative Evaluation of Bicycle and Dobutamine Stress Echocardiography With Perfusion Scintigraphy and Bicycle Electrocardiogram for Identification of Coronary Artery Disease

Am J Cardiol. 1993 Sep 1;72(7):555-9. doi: 10.1016/0002-9149(93)90351-c.

Abstract

In 66 patients with suspected coronary artery disease (CAD), exercise electrocardiography (ECG), exercise echocardiography, dobutamine stress echocardiography (dosage, 5 to 40 micrograms/kg/min), single-photon emission computed tomography (SPECT) using methoxy-isobutyl-isonitrile (MIBI) and coronary angiography were performed prospectively to compare methods for detecting CAD. CAD was defined as 70% luminal area stenosis in at least 1 coronary artery at coronary angiography. Significant CAD was present in 50 patients. Compared with exercise ECG, exercise echocardiography, dobutamine stress echocardiography and MIBI-SPECT had a significantly higher sensitivity (52% vs 80, 79 and 89%; p < 0.01, p < 0.01 and p < 0.001, respectively). There were no significant differences in sensitivity between exercise echocardiography, dobutamine stress echocardiography and MIBI-SPECT. Specificity of MIBI-SPECT was lowest (71%), whereas exercise ECG, exercise and dobutamine echocardiography had higher specificities (93, 87 and 81%, respectively). Significance, however, was not achieved. Differences in overall accuracy between exercise echocardiography (82%), dobutamine stress echocardiography (80%) and MIBI-SPECT (85%) were not significant. Comparison with accuracy of exercise ECG (62%) was significant (p < 0.05, p < 0.05 and p < 0.01, respectively). In 1-vessel disease, exercise ECG had a lower sensitivity (45%) than exercise and dobutamine echocardiography and MIBI-SPECT (79, 78 and 84%; p < 0.02, p < 0.02 and p < 0.01, respectively). Regarding the 24 patients with false-negative exercise ECG results, 67% had positive exercise echocardiography findings, 71% positive dobutamine echocardiography results and 84% positive technetium-99m MIBI-SPECT results.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Coronary Angiography
  • Coronary Disease / diagnosis*
  • Coronary Disease / epidemiology
  • Dobutamine*
  • Echocardiography / methods*
  • Echocardiography / statistics & numerical data
  • Electrocardiography / methods*
  • Electrocardiography / statistics & numerical data
  • Evaluation Studies as Topic
  • Exercise Test / methods*
  • Exercise Test / statistics & numerical data
  • Female
  • Heart / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity
  • Technetium Tc 99m Sestamibi
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Tomography, Emission-Computed, Single-Photon / statistics & numerical data

Substances

  • Dobutamine
  • Technetium Tc 99m Sestamibi