Comparison of adenosine, dobutamine, and exercise radionuclide ventriculography in the detection of coronary artery disease

Cardiology. 1997 Mar-Apr;88(2):180-8. doi: 10.1159/000177327.

Abstract

The diagnostic values of adenosine, dobutamine, and exercise radionuclide ventriculography (RNVG) in the detection of coronary artery disease (CAD), and the characteristics of those patients who showed myocardial ischemia during the infusion of adenosine or dobutamine were assessed in 41 patients with suspected CAD. Sensitivity, specificity, and accuracy, respectively, for detecting patients with CAD were 35 (p < 0.01 vs. exercise RNVG), 100 and 46% (p < 0.01 vs. exercise RNVG) with adenosine RNVG, 74, 100 and 78% with dobutamine RNVG and 88, 71 and 85% with exercise RNVG. There was a significant difference in physiologic parameters during the provocation of ischemia by adenosine versus exercise RNVG, although these parameters were similar by dobutamine and exercise RNVG. Stepwise discriminant analysis revealed that the number of stenotic vessels was an important and independent predictor for the myocardial ischemia induced by each stress; the peak filling rate was the only predictor for adenosine-induced ischemia. Dobutamine induced myocardial ischemia in a way similar to that of exercise, and was more useful than adenosine for pharmacologic stress RNVG. The mechanism of the adenosine-induced ischemia seemed to differ from that of the ischemia induced by dobutamine or exercise, and to be closely associated with left ventricular diastolic function.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adenosine*
  • Adult
  • Aged
  • Cardiotonic Agents*
  • Coronary Disease / diagnosis*
  • Coronary Disease / physiopathology
  • Diastole / physiology
  • Dobutamine*
  • Exercise Test*
  • Female
  • Gated Blood-Pool Imaging*
  • Hemodynamics / physiology
  • Humans
  • Male
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / physiopathology
  • Vasodilator Agents*
  • Ventricular Function, Left / physiology

Substances

  • Cardiotonic Agents
  • Vasodilator Agents
  • Dobutamine
  • Adenosine