Enhanced Sensitivity of Dobutamine Stress Echocardiography by Observing Wall Motion Abnormalities During the Recovery Phase After Acute Beta-Blocker Administration
Dobutamine stress echocardiography (DSE) has a modest sensitivity for detecting single-vessel coronary artery disease (CAD). This study assessed the additional diagnostic value of new or worsening wall motion abnormalities during recovery after acute administration of β blockers. The study populatio...
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| Veröffentlicht in: | The American journal of cardiology 2006-02, Vol.97 (4), p.462-465 |
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| container_title | The American journal of cardiology |
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| creator | Karagiannis, Stefanos E. Bax, Jeroen J. Elhendy, Abdou Feringa, Herman H.H. Cokkinos, Dennis V. van Domburg, Ron Simoons, Maarten Poldermans, Daniel |
| description | Dobutamine stress echocardiography (DSE) has a modest sensitivity for detecting single-vessel coronary artery disease (CAD). This study assessed the additional diagnostic value of new or worsening wall motion abnormalities during recovery after acute administration of β blockers. The study population consisted of 200 patients (mean 59 ± 11 years of age, 144 men), who underwent DSE. Images were acquired at rest, low dose, peak dose, and during recovery. Patients received intravenous metoprolol (1 to 5 mg/min). The dose was adjusted to achieve a recovery heart rate within a 10% range of heart rate at rest. Coronary angiography was performed within 2 months. Inducible new wall motion abnormalities were observed in 168 patients (84%) at peak stress. An additional 14 patients (7%) developed new or worsening wall motion abnormalities during recovery. CAD was detected in 182 patients (86 had single-vessel CAD). Sensitivity, specificity, and accuracy of DSE were 88%, 65%, and 73% at peak stress and 97%, 65%, and 74% during recovery. Sensitivity was particularly higher during recovery than during peak stress in patients with single-vessel CAD (98% vs 81%, p |
| doi_str_mv | 10.1016/j.amjcard.2005.09.075 |
| format | Article |
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This study assessed the additional diagnostic value of new or worsening wall motion abnormalities during recovery after acute administration of β blockers. The study population consisted of 200 patients (mean 59 ± 11 years of age, 144 men), who underwent DSE. Images were acquired at rest, low dose, peak dose, and during recovery. Patients received intravenous metoprolol (1 to 5 mg/min). The dose was adjusted to achieve a recovery heart rate within a 10% range of heart rate at rest. Coronary angiography was performed within 2 months. Inducible new wall motion abnormalities were observed in 168 patients (84%) at peak stress. An additional 14 patients (7%) developed new or worsening wall motion abnormalities during recovery. CAD was detected in 182 patients (86 had single-vessel CAD). Sensitivity, specificity, and accuracy of DSE were 88%, 65%, and 73% at peak stress and 97%, 65%, and 74% during recovery. Sensitivity was particularly higher during recovery than during peak stress in patients with single-vessel CAD (98% vs 81%, p <0.001). In conclusion, assessment of wall motion abnormalities during the recovery phase after acute β blockade improves sensitivity of DSE, particularly in patients with single-vessel CAD.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2005.09.075</identifier><identifier>PMID: 16461037</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adrenergic beta-Antagonists - administration & dosage ; Adrenergic beta-Antagonists - pharmacology ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiovascular disease ; Coronary Angiography ; Coronary Disease - physiopathology ; Dobutamine ; Echocardiography, Stress ; Female ; Humans ; Male ; Medical imaging ; Medical sciences ; Metoprolol - administration & dosage ; Metoprolol - pharmacology ; Middle Aged ; Sensitivity and Specificity ; Ultrasonic imaging</subject><ispartof>The American journal of cardiology, 2006-02, Vol.97 (4), p.462-465</ispartof><rights>2006 Elsevier Inc.</rights><rights>2006 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. 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This study assessed the additional diagnostic value of new or worsening wall motion abnormalities during recovery after acute administration of β blockers. The study population consisted of 200 patients (mean 59 ± 11 years of age, 144 men), who underwent DSE. Images were acquired at rest, low dose, peak dose, and during recovery. Patients received intravenous metoprolol (1 to 5 mg/min). The dose was adjusted to achieve a recovery heart rate within a 10% range of heart rate at rest. Coronary angiography was performed within 2 months. Inducible new wall motion abnormalities were observed in 168 patients (84%) at peak stress. An additional 14 patients (7%) developed new or worsening wall motion abnormalities during recovery. CAD was detected in 182 patients (86 had single-vessel CAD). Sensitivity, specificity, and accuracy of DSE were 88%, 65%, and 73% at peak stress and 97%, 65%, and 74% during recovery. Sensitivity was particularly higher during recovery than during peak stress in patients with single-vessel CAD (98% vs 81%, p <0.001). In conclusion, assessment of wall motion abnormalities during the recovery phase after acute β blockade improves sensitivity of DSE, particularly in patients with single-vessel CAD.</description><subject>Adrenergic beta-Antagonists - administration & dosage</subject><subject>Adrenergic beta-Antagonists - pharmacology</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Coronary Angiography</subject><subject>Coronary Disease - physiopathology</subject><subject>Dobutamine</subject><subject>Echocardiography, Stress</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Metoprolol - administration & dosage</subject><subject>Metoprolol - pharmacology</subject><subject>Middle Aged</subject><subject>Sensitivity and Specificity</subject><subject>Ultrasonic imaging</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkdGK1DAUhoso7rj6CEoQ9K5j0iRNeyWzu7MqrKy4ipchTU-2GdtmTNKBeR5fdFOmsOCNV4ccvvOfQ74se03wmmBSftit1bDTyrfrAmO-xvUaC_4kW5FK1DmpCX2arTDGRV4TVp9lL0LYpSchvHyenZGSlQRTscr-bsdOjRpadAdjsNEebDwiZ9CVa6aoBjsCuoseQkBb3bl5oXX3Xu27I2qO6LYJ4A92vEe_VN-jry5aN6JNMzo_qD7FQUBXk5-B2AH6DtodwB_Rt04FQBsTwaONniKgC4gqv-id_j232rTYhujVnPcye2ZUH-DVUs-zn9fbH5ef85vbT18uNze5ZgWOOYMWa8NKBpyA4boVNeWaG0F0rbkQDW0oFKw1hBUF44bXgE1T0AYbJThr6Xn2_pS79-7PBCHKwQYNfa9GcFOQpSipKHmZwLf_gDs3-THdJguKaVnRiiWInyDtXQgejNx7Oyh_lATLWaHcyUWhnBVKXMukMM29WcKnZoD2cWpxloB3C6CCVr3xyZ8Nj5zgpGIVSdzHEwfpzw4WvAzawuzaetBRts7-55QHpOG_fA</recordid><startdate>20060215</startdate><enddate>20060215</enddate><creator>Karagiannis, Stefanos E.</creator><creator>Bax, Jeroen J.</creator><creator>Elhendy, Abdou</creator><creator>Feringa, Herman H.H.</creator><creator>Cokkinos, Dennis V.</creator><creator>van Domburg, Ron</creator><creator>Simoons, Maarten</creator><creator>Poldermans, Daniel</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20060215</creationdate><title>Enhanced Sensitivity of Dobutamine Stress Echocardiography by Observing Wall Motion Abnormalities During the Recovery Phase After Acute Beta-Blocker Administration</title><author>Karagiannis, Stefanos E. ; Bax, Jeroen J. ; Elhendy, Abdou ; Feringa, Herman H.H. ; Cokkinos, Dennis V. ; van Domburg, Ron ; Simoons, Maarten ; Poldermans, Daniel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c420t-4ed0cf464e51ef5cd7935c5f71c9c577b3b3e24df142245f59e0fb23b0fa754d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adrenergic beta-Antagonists - administration & dosage</topic><topic>Adrenergic beta-Antagonists - pharmacology</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular disease</topic><topic>Coronary Angiography</topic><topic>Coronary Disease - physiopathology</topic><topic>Dobutamine</topic><topic>Echocardiography, Stress</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Metoprolol - administration & dosage</topic><topic>Metoprolol - pharmacology</topic><topic>Middle Aged</topic><topic>Sensitivity and Specificity</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karagiannis, Stefanos E.</creatorcontrib><creatorcontrib>Bax, Jeroen J.</creatorcontrib><creatorcontrib>Elhendy, Abdou</creatorcontrib><creatorcontrib>Feringa, Herman H.H.</creatorcontrib><creatorcontrib>Cokkinos, Dennis V.</creatorcontrib><creatorcontrib>van Domburg, Ron</creatorcontrib><creatorcontrib>Simoons, Maarten</creatorcontrib><creatorcontrib>Poldermans, Daniel</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karagiannis, Stefanos E.</au><au>Bax, Jeroen J.</au><au>Elhendy, Abdou</au><au>Feringa, Herman H.H.</au><au>Cokkinos, Dennis V.</au><au>van Domburg, Ron</au><au>Simoons, Maarten</au><au>Poldermans, Daniel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Enhanced Sensitivity of Dobutamine Stress Echocardiography by Observing Wall Motion Abnormalities During the Recovery Phase After Acute Beta-Blocker Administration</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2006-02-15</date><risdate>2006</risdate><volume>97</volume><issue>4</issue><spage>462</spage><epage>465</epage><pages>462-465</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Dobutamine stress echocardiography (DSE) has a modest sensitivity for detecting single-vessel coronary artery disease (CAD). This study assessed the additional diagnostic value of new or worsening wall motion abnormalities during recovery after acute administration of β blockers. The study population consisted of 200 patients (mean 59 ± 11 years of age, 144 men), who underwent DSE. Images were acquired at rest, low dose, peak dose, and during recovery. Patients received intravenous metoprolol (1 to 5 mg/min). The dose was adjusted to achieve a recovery heart rate within a 10% range of heart rate at rest. Coronary angiography was performed within 2 months. Inducible new wall motion abnormalities were observed in 168 patients (84%) at peak stress. An additional 14 patients (7%) developed new or worsening wall motion abnormalities during recovery. CAD was detected in 182 patients (86 had single-vessel CAD). Sensitivity, specificity, and accuracy of DSE were 88%, 65%, and 73% at peak stress and 97%, 65%, and 74% during recovery. Sensitivity was particularly higher during recovery than during peak stress in patients with single-vessel CAD (98% vs 81%, p <0.001). In conclusion, assessment of wall motion abnormalities during the recovery phase after acute β blockade improves sensitivity of DSE, particularly in patients with single-vessel CAD.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>16461037</pmid><doi>10.1016/j.amjcard.2005.09.075</doi><tpages>4</tpages></addata></record> |
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| subjects | Adrenergic beta-Antagonists - administration & dosage Adrenergic beta-Antagonists - pharmacology Biological and medical sciences Cardiology. Vascular system Cardiovascular disease Coronary Angiography Coronary Disease - physiopathology Dobutamine Echocardiography, Stress Female Humans Male Medical imaging Medical sciences Metoprolol - administration & dosage Metoprolol - pharmacology Middle Aged Sensitivity and Specificity Ultrasonic imaging |
| title | Enhanced Sensitivity of Dobutamine Stress Echocardiography by Observing Wall Motion Abnormalities During the Recovery Phase After Acute Beta-Blocker Administration |
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