Comparative diagnostic value of dobutamine stress echocardiography and stress thallium-201 single-photon-emission computed tomography for detecting coronary artery disease in women

Coron Artery Dis. 1996 Nov;7(11):831-5. doi: 10.1097/00019501-199611000-00007.

Abstract

Background: The non-invasive diagnosis of coronary artery disease in women remains a difficult clinical problem. The aim of this study was to investigate the comparative diagnostic accuracy of dobutamine stress echocardiography and stress thallium-201 single-photon-emission computed tomography (SPECT) in women who were suspected to have coronary artery disease.

Methods: We studied 70 consecutive women who had not had a previous myocardial infarction (mean age 65 years) who underwent dobutamine stress echocardiography and quantitative coronary angiography. Sixty-one of the 70 women were also subjected to thallium-201 SPECT, with exercise or dipyridamole administration as the stressor, during the same period. A positive diagnosis was based on the detection of inducible wall motion abnormality and the presence of stress-induced abnormalities of perfusion.

Results: No significant complication occurred in any patient during dobutamine stress echocardiography (peak dose 31 +/- 9 micrograms/kg per min, atropine administered to 13 patients, peak heart rate 120 +/- 19 beats/min). Coronary artery disease (> or = 50% diameter stenosis) was present in 20 (29%) patients, nine with one-vessel and 11 with multivessel disease. The sensitivity, specificity and diagnostic accuracy of dobutamine stress echocardiography for detecting coronary artery disease were 75, 92 and 87% respectively. In 61 patients who underwent both stress tests, the sensitivity, specificity and accuracy of dobutamine stress echocardiography and stress thallium-201 SPECT were 72 versus 78%, 91 versus 70% (P < 0.05) and 85 versus 72%, respectively.

Conclusions: Dobutamine stress echocardiography appears to be of comparable sensitivity and higher specificity with stress thallium-201 SPECT for noninvasive detection of coronary artery disease in women.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Atropine
  • Cardiotonic Agents*
  • Coronary Angiography
  • Coronary Disease / diagnosis*
  • Coronary Disease / physiopathology
  • Dobutamine*
  • Echocardiography / methods*
  • Electrocardiography
  • Exercise Test / methods
  • Female
  • Hemodynamics
  • Humans
  • Middle Aged
  • Parasympatholytics
  • Retrospective Studies
  • Sensitivity and Specificity
  • Thallium Radioisotopes*
  • Tomography, Emission-Computed, Single-Photon / methods*

Substances

  • Cardiotonic Agents
  • Parasympatholytics
  • Thallium Radioisotopes
  • Dobutamine
  • Atropine