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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Circ+Cardiovasc+Imaging
2017 ; 10
(4
): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Frequency, Predictors, and Implications of Abnormal Blood Pressure Responses
During Dobutamine Stress Echocardiography
#MMPMID28351907
Abram S
; Arruda-Olson AM
; Scott CG
; Pellikka PA
; Nkomo VT
; Oh JK
; Milan A
; Abidian MM
; McCully RB
Circ Cardiovasc Imaging
2017[Apr]; 10
(4
): ä PMID28351907
show ga
BACKGROUND: It is not known whether abnormal blood pressure (BP) responses during
dobutamine stress echocardiography (DSE) are associated with abnormal test
results, nor if such results indicate obstructive coronary artery disease (CAD).
We sought to define the frequency of abnormal BP responses during DSE and their
impact on accuracy of test results. METHODS AND RESULTS: We studied 21 949
patients who underwent DSE at Mayo Clinic, Rochester, MN, grouped by peak
systolic BP achieved during the test. We also analyzed a subgroup who underwent
coronary angiography within 30 days after positive DSE. The positive predictive
value of DSE was calculated for each BP group. Patients with hypertensive
response (n=1905; 9%) were more likely to have positive DSE than those with
normal (n=19 770; 90%) or hypotensive (n=274; 1%) BP responses (32% versus 21%
versus 23%, respectively; P<0.0001). Angiography, performed in 1126 patients,
showed obstructive CAD (?50% stenosis) in 814 patients and severe CAD (?70%
stenosis) in 708 patients. Positive predictive value of DSE was similar for
patients who had hypertensive and normal BP responses (69% versus 73%; P=0.3),
considering 50% stenosis cut point. The proportion of severe CAD (?70% stenosis)
was lower in patients who had hypertensive response compared with those who had
normal BP response (54% versus 65%; P=0.005). CONCLUSIONS: Patients with
hypertensive response during DSE are more likely to have stress-induced
myocardial ischemia compared with those with normal or hypotensive BP responses
but are not more likely to have false-positive DSE results. They are, however,
less likely to have higher grade or multivessel CAD.