A DIGITALIS TECHNIKA HATASA A DOBUTAMINTERHELESES ECHOKARDIOGRAFIA ERTEKELESENEK TANULOFAZISARA

Introduction - The combination of dobutamine stress test with two-dimensional echocardiography has become a standard technique for the defection of myocardial ischemia. The purpose of this study was to define the diagnostic accuracy of the test using digital technology and the time period that is necessary to become well trained in the technique. Patients and Methods - Dobutamine stress test was performed in 51 patients and wall section abnormalities assessed by 2-dimensional echocardiography were compared to the results of coronary angiography. The positive inotropic effect of dobutamine was assessed by the measurement of left ventricular outflow velocity. Results - Fifty studies were considered adequate to asses diagnostic accuracy: the sensitivity and specificity of the dobutamine stress test was 83% and 53% respectively. However the division of patients into two groups, the last 25 patients showed a high diagnostic accuracy comparable to literature values: 83% sensitivity and 85% specificity in contrast with the first 25 patients in whom sensitivity was 82% but specificity only 25%. The left ventricular outflow velocity was 0,97 ± 0,14 m/s before the test and the dose producing 30% increase of this velocity was considered the low effective dose (mean 13 μg/kg/min). Conclusion - Using digital technology a minimum of 25 studies is required for the independent performance and interpretation of dobutamine stress echocardiography. The increase of left ventricular outflow velocity can be utilised to determine the dobutamine dose needed for the assessment of viability.