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Abstract
Background
Two-dimensional echocardiography performed during incremental infusion of dobutamine has been shown to be a safe and accurate method for detection of coronary artery disease in patients who are unable to undergo conventional exercise testing. A significant proportion of these patients are referred for evaluation before undergoing noncardiac surgery.
Method
To assess the value of dobutamine stress echocardiography (DSE), for assessment of preoperative cardiac risk, 88 patients (male: 32, female: 56, mean age: 60 years) were evaluated. Patients records were reviewed to determine the short-term outcome of surgery. Significant cardiac events were defined as unstable angina, myocardial infarction and sudden cardiac death occurred before discharge. Intravenous dobutamine was infused in a graded fashion (10 to 45μg/kg/min in 3 minutes stages), with two-dimensional echocardiographic monitoring of segmental wall motion of left ventricle.
Results
1) The major reasons underwent dobutamine stress echocardiography were abnormalities of ECG such as ST-T changes, abnormal Q wave (65%: 64 of 98 patients) and history of coronary artery disease (29%: 28 of 98 patients).
2) Of the 88 patients who underwent noncardiac surgery, 85 (97%) patients were negative response in dobutamine stress echocardiography, and no patients had cardiac events, also 3 (3%) patients who had positve response did not occur cardiac events.
3) No major adverse effects occurred with stress test in any patient.
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Table 1.
Reasons of dobutamine stress echo(n = 98)
| ECG abnormality | |
|---|---|
| Complete RBBB | 1 |
| ST-T changes | 57 |
| Abnormal Q-wave | 7 |
| Arrhythmias | 5 |
| Angina pectoris | 25 |
| Previous MI | 3 |
Table 2.
Causes of surgical procedures(n = 88)
| Bone fracture | 22 |
| Arthritis | 14 |
| HIVD | 13 |
| GB and CBD stone | 9 |
| Cancer | 8 |
| Arterosclerosis obliterans | 4 |
| Acute appendicitis | 3 |
| Avascular necrosis | 3 |
| Uterine prolapse | 3 |
| Chronic otitis media | 2 |
| Others | 7 |
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