The Value Of Real-time Three-dimensional Dobutamine Stress Echocardiography In The Diagnosis Of Coronary Artery Disease

Objective： To evaluate the sensitivity, specificity and accuracy of real-timethree-dimensional dobutamine stress echocardiography in the diagnosis of coronaryartery disease.Method:28patients suspected of coronary artery disease (CAD) were selected. The restheart rate and blood pressure was recorded. All patients underwent real-timethree-dimensional Dobutamine stress echocardiography test. Dobutamine was injected5μg/kg/min intravenously，followed by10μg/kg/min,20μg/kg/min and30μg/kg/min inthree minute stages. Heart rate, blood pressure and electrocardiogram were recordedsimultaneously. The real-time three-dimensional (RT3D) images were record at baselinestate, each stress stage and after the study. The images were assessed by regionalejection fraction(rEF) and wall motion score index(WMSI).The parameters of thesetwo modalities were compared with coronary angiography(CAG).Evaluate the value ofreal-time three-dimensional dobutamine stress echocardiography in diagnosis ofcoronary artery disease.Results:26patients completed the stress study successfully. These two modalitieshaving no significant difference in detecting coronary lesions and diagnosis of CADcompared with the CAG（P＞0.05）.rEF and WMSI modalities showed satisfactoryconsistency in detecting coronary lesions compared with the result of CAG(Kappa valueof0.662and0.591respectively). The diagnostic parameters of the two modalities indetecting vessel lesions: sensitivity84%VS75%，specificity83%VS87%, accuracy83%VS82%，PPV77%VS80%，NPV88%VS83%.The diagnostic parameters of thetwo modalities in diagnosis of coronary artery disease: sensitivity83%VS78%，specificity88%VS88%，accuracy84%VS81%，PPV94%VS93%，NPV70%VS64%.Conclusion: Real-time three-dimensional Dobutamine stress echocardiography is an effective and safe technique in assessing coronary artery disease and detecting coronarylesions with high sensitivity and specificity and mild adverse reactions.