Detection of coronary artery disease using dobutamine stress echocardiography in patients with an abnormal resting electrocardiograph

Purpose. We assessed the value of dobutamine stress echocardiography for the detection of coronary artery disease in patients with chest pain and an abnormal resting electrocardiograph (ECG). Methods. Dobutamine stress echocardiography was performed in a standard fashion. Significant coronary artery disease was defined as a >50% luminal diameter stenosis on coronary angiography. Results. The sensitivity, specificity, positive and negative predictive value of dobutamine stress echocardiography for the detection of coronary artery disease in 218 patients were 89, 50, 95 and 32%, respectively. The sensitivity for detection of multi-, double- and single vessel disease were 97, 82 and 81%, respectively. The sensitivity for the detection of coronary artery disease in a subgroup of 69 patients by treadmill exercise testing was 37%. Conclusion. Dobutamine stress echocardiography is better than exercise ECG for the detection of significant coronary artery disease. The negative predictive value of dobutamine stress echocardiography in this patient group is low.