Head to Head Comparison of Stress Echocardiography with Exercise Electrocardiography for the Detection of Coronary Artery Stenosis in Women.
10.4250/jcu.2016.24.2.135
- Author:
Mi Na KIM
1
;
Su A KIM
;
Yong Hyun KIM
;
Soon Jun HONG
;
Seong Mi PARK
;
Mi Seung SHIN
;
Myung A KIM
;
Kyoung Soon HONG
;
Gil Ja SHIN
;
Wan Joo SHIM
Author Information
1. Department of Cardiology, Korea University Anam Hospital, Seoul, Korea. wjshimmd@unitel.co.kr
- Publication Type:Original Article
- Keywords:
Dobutamine stress echocardiography;
Exercise-stress electrocardiography;
Coronary artery disease;
Women
- MeSH:
Ambulatory Care Facilities;
Chest Pain;
Coronary Angiography;
Coronary Artery Disease;
Coronary Stenosis*;
Coronary Vessels*;
Diagnosis;
Echocardiography, Stress*;
Electrocardiography*;
Exercise Test;
Female;
Head*;
Heart Rate;
Humans;
Ischemia;
Sensitivity and Specificity
- From:Journal of Cardiovascular Ultrasound
2016;24(2):135-143
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Exercise-stress electrocardiography (ECG) is initially recommended for the diagnosis of coronary artery disease. But its value has been questioned in women because of suboptimal diagnostic accuracy. Stress echocardiography had been reported to have comparable test accuracy in women. But the data comparing the diagnostic accuracy of exercise-stress ECG and stress echocardiography directly are few. The aim of the study was to compare the diagnostic accuracy of exercise-stress ECG and dobutamine stress echocardiography (DSE) in Korean women. METHODS: 202 consecutive female patients who presented with chest pain in outpatient clinic, and who underwent treadmill exercise test (TET), DSE and coronary angiography were included for the study. The diagnostic accuracy TET and DSE were calculated by the definition of > 50% or > 75% coronary artery stenosis (CAS). RESULTS: The sensitivity and specificity were higher with DSE (70.4, 94.6%) than TET (53.7, 73.6%) for detection of > 50% CAS. The higher accuracy of DSE was maintained after exclusion of the patients who could not achieve over 85% age predicted heart rate before ischemia induction. DSE also showed greater diagnostic accuracy than TET by > 75% CAS criteria, and in subsets of patient with intermediate pretest probability. CONCLUSION: In the diagnosis of CAS, DSE showed higher accuracy than TET in female patients who presented with chest pain. As well as the test accuracy, adequate stress was more feasible with DSE than TET. These finding suggests DSE may be used as the first-line diagnostic tool in the detection of CAS in women with chest pain.
