24-hour ECG Holter monitoring and Dobutamine-echocardiography in patients suffering from stenocardia with exercise ECG test contraindications
Jerzy K. Wranicz, Mariusz Strzondała, M. Maciejewski, J. Ruta, H. Bolińska
Med Sci Monit 1999; 5(5): CR915-919
The aim of this study was to assess the usefulness of 24-hour ECG Holter monitoring (HM) and Dobutamine Echo (DE) performed simultaneously in the detection of patients suffering from stenocardia who demonstrate significant coronary artery changes.We retrospectively analysed a group of 71 pts (56 M, 15 W, aged between 42 and 59 years, mean 51±6), with the Leriche syndrome or an abdominal aorta aneurysm (exercise test contraindications), suffering from stenocardia that were qualified for coronarography. All patients demonstrated standard ECG ischemic changes and were qualified for different vascular surgical procedures. 39 pts presented with significant coronary artery stenosis (at least 75%): 3 vessels - 6 pts, 2 vessels - 14 pts, 1 vessel - 19 pts. Prior to coronarography we performed HM and DE simultaneously.We compared both non-invasive method results separately and together with coronarographic findings. The sensitivity, specificity, positive predictive value, negative predictive value and test accuracy of Dobutamine Echo were 80, 94, 94, 79, 86%, respectively that of Holter monitoring 62, 72, 68, 72, 70%, respectively and together 92, 81, 86, 90, 87%, respectively.
Conclusion: HM and DE performed simultaneously increase the detectability of patients with the Leriche syndrome or an abdominal aorta aneurysm that demonstrates significant coronary artery changes.
Keywords: Dobutamine-echocardiography, 24-hour ECG monitoring, Leriche syndrome, stenocardia, abdominal aorta aneurysm