DIAGNOSTIC YIELD OF STRESS ECHOCARDIOGRAPHY IN CORONARY ARTERY DISEASE PATIENTS

Objective: To find out the sensitivity and specificity of dobutamine stress echocardiography in comparison to the angiographic findings.Methodology: This Cross-Sectional study was conducted at cardiology department, Lady Reading Hospital Peshawar, from January to December 2007. Data was collected by non probability purposive sampling technique. Study patients underwent both dobutamine stress echo and coronary angiography, after taking an informed consent. Dobutamine stress echo was performed according to standard protocol.Results: Total of 50 patients, whose mean age was 51.6+/-9.7, were studied. Men were 35 (70%) and women were 15 (30%). Dobutamine was infused (10 to 40 micrograms/kg/min) in 3 minutes intervals. The inducible ischemia was detected in total 33(66%) patients. Seven patients (14%) had only resting wall motion abnormalities with no change by dobutamine stress. These patients were also taken as positive for ischemia. Coronary angiography showed 43/50 (86%) patients had > 50% stenosis in at least one coronary artery. Compared with coronary angiography, the sensitivity, specificity, positive and negative predictive values and accuracy of dobutamine stress echo for detection of coronary artery disease were 91%, 86%, 97%, 60%and 90% respectively. The sensitivities for SVD, DVD and TVD were 76%, 89% and 100% respectively.Conclusion: Dobutamine stress echo is a sensitive and specific method in non invasive diagnosis of suspected CAD. It is highly sensitive for multivessel disease as compared to single vessel disease.