Author + information
- Hakan Akıllı,
- Mehmet Kayrak,
- Hajrudin Alibasiç,
- Alpay Arıbaş,
- Umuttan Doğan,
- Mehmet Yazıcı,
- Hasan Gök and
- Kurtuluş Özdemir
Dobutamine stress echocardiography (DSE) is especially important test in evaluating patients have limited exercise effort capacity, in order to determine the existence and extent of myocardial ischemia, assessment of the myocardial viability before revascularization and evaluation of the heart valve diseases. In addition to being non-invasive, other most important advantages are radiation-free and reliability. As for the disadvantages, it requires a lot of experience, it is depend on the operator and it is time consuming. Since the 2005th, DSE was used to assessment of myocardial ischemia / viability and the heart valve diseases in our clinic. Here, our purpose was to share our experiences on this topic.
DSE reports performed between 2007-2013 were analyzed retrospectively. A total of 1987 DSE reports had been screened during this period, and 36 patients who terminated early test due to dobutamine intolerance and 71 patients with insufficient medical records were excluded. A total of 1880 patients and their demographic characteristics, DSE indications, complications during the procedure and the results of DSE were analyzed.
By year, the number of patients underwent DSE presented in table 1. Some of the demographic characteristics of the patients, developed complications during DSE and indications of DSE were shown in table 2. The most common indication of DSE was assessment of myocardial ischemia (69.5%). The most common complication of DSE was nausea in 371 patients (19.7%). No death case was reported during the DSE. 28 patients (1.5%) had developed ventricular tachycardia, and none of them was treated with the shock therapy. 52 patients (2.8%) had developed atrial fibrillation. ST elevation was seen in 10 patients (0.5%). Hibernating myocardium was determined and myocardial revascularization (percutaneous coronary intervention or bypass) was performed in 191 of the 527 patients (36.2%) who assessed for viable tissue. Out of 1307 patients, 373 patients (%28.5) were diagnosed with ischemia and 260 patients out of them were performed the coronary angiography. In accordance with the results of the coronary angiography, 99 patients were treated with the medical therapy, 117 patients underwent to percutaneous coronary intervention, and 44 patients were decided to a bypass. Due to the low circulation and low-gradient aortic stenosis, DSE was performed, and in 19 of 46 patients (41.3%), replacement of the aortic valve was suggested.
The results of DSE can be shown by comparing them to the myocardial perfusion scintigraphy. The negative effects of medical radiation environment is better understood with each passing day, and as a result, health organizations and governments should extend the number of laboratories where DSE can be performed and the cardiologists should be encouraged to think about this topic as well.
|Years||Number of dobutamine stress echocardiography|
|2013 (including first 5 month)||298|
|Number of patients||1880|
|Mean age (years)||61.5±11.3|
|Male gender n (%)||1094 (58.2)|
|Female gender n (%)||786 (41.8)|
|Hypertension n (%)||724 (38.5)|
|Diabetes mellitus n (%)||501 (26.6)|
|Known CAD n (%)||776 (41.3)|
|Investigation of miyocardial ischemia (%)||1307 (69.5)|
|Investigation of myocardial viability n (%)||527 (28.1)|
|Evaluation of aortic stenosis n (%)||46 (2.4)|
|Nausea during DSE n(%)||371 (19.7)|
|Atrial fibrillation during DSE n (%)||52 (2.8)|
|Ventricular tachycardia during DSE n (%)||28 (1.5)|
|ST elevation during DSE n (%)||10 (0.5)|
DSE: Dobutamine stress echocardiography, CAD: Coronary artery disease