Table 8

Summary of Studies Examining the Value of Dobutamine Stress Echocardiography for Preoperative Risk Assessment

ReferencenPatients With Ischemia, %Events (MI/Death) (n)Criteria for Abnormal TestMI or DeathComments
Positive Predictive ValueNegative Predictive Value
Lane et al., 1991 (237)38508% (3)New WMA16% (3/19)100% (19/19)Vascular and general surgery
Lalka et al., 1992 (238)605015% (9)New or worsening WMA23% (7/30)93% (28/30)Multivariate analysis
Eichelberger et al., 1993 (239)75363% (2)New or worsening WMA7% (2/27)100% (48/48)Managing physicians blinded to DSE results
Langan et al., 1993 (240)74244% (3)New WMA or ECG changes17% (3/18)100% (56/56)
Poldermans et al., 1993 (160)131274% (5)New or worsening WMA14% (5/35)100% (96/96)Multivariate analysis; managing physicians blinded to DSE results
Dávila-Román et al., 1993 (242)88232% (2)New or worsening WMA10% (2/20)100% (68/68)Included long-term follow-up
Poldermans et al., 1995 (241)302246% (17)New or worsening WMA24% (17/72)100% (228/228)Multivariate analysis
Shafritz et al., 1997 (243)4202% (1)New or worsening WMAN/A97% (41/42)
Plotkin et al., 1998 (146)8083% (2)New or worsening WMA, ECG changes, and/or symptoms of chest pain or dyspnea33% (2/6)100% (74/74)Orthotopic liver transplantation
Ballal et al., 1999 (244)233173% (7)New or worsening WMA0% (0/39)96% (187/194)Included long-term follow-up
Bossone et al., 1999 (149)4692% (1)New or worsening WMA25% (1/4)100% (42/42)Lung volume reduction surgery; included long-term follow-up
Das et al., 2000 (245)530406% (32)New or worsening WMA or failure to develop hyperdynamic function15% (32/214)100% (316/316)Multivariate analysis; nonvascular surgery
Boersma et al., 2001 (246)1097204% (44)New or worsening WMA14% (30/222)98% (861/875)Major vascular surgery; multivariate analysis; long-term follow-up
Morgan et al., 2002 (247)7850% (0)Undefined0% (0/4)100% (100%)High-risk noncardiac surgery in one third of patients
Torres et al., 2002 (248)1054710% (10)New or worsening WMA18% (9/49)98% (55/56)Multivariate analysis; vascular surgery in 82% of patients; long-term follow-up
Labib et al., 2004 (249)42972% (10)New or worsening WMA9% (3/32)98% (390/397)Vascular surgery in 30% of patients

DSE indicates dobutamine stress echocardiogram; ECG, electrocardiogram; MI, myocardial infarction; n, number of patients who underwent surgery; N/A, not available; and WMA, wall-motion abnormality.

  • Numbers in parentheses refer to number of patients/total in group.

  • Intervening revascularization in 9 ischemic patients (23%).