Why the study?
Does isoproterenol infusion stress two-dimensional echocardiography accurately diagnose coronary artery disease in elderly patients compared to exercise ECG and exercise radionuclide angiocardiography?
Does isoproterenol infusion stress two-dimensional echocardiography accurately diagnose coronary artery disease in elderly patients compared to exercise ECG and exercise radionuclide angiocardiography?
Isoproterenol stress echocardiography is a safe and specific alternative to exercise testing for diagnosing coronary artery disease in elderly patients who cannot adequately perform dynamic exercise.
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ISP-2-DE may support CAD evaluation in elderly patients unable to exercise; hypothesis-generating and leaves open need for prospective validation.
Since a dynamic exercise stress test cannot always be performed adequately in elderly patients, an alternative method is needed for evaluation of coronary reserve. We studied two-dimensional echocardiographic (2-DE) and electrocardiographic (ECG) responses to infusion of isoproterenol (ISP) at a rate of 0.02 micrograms/Kg/min in 40 elderly patients with chest pain. The results were compared with exercise ECG (EX-ECG) tests and exercise radionuclide angiocardiography (EX-RNA) in 13 of these patients. No serious complications were encountered in the ISP test. The diagnostic sensitivity for coronary artery disease (CAD) was 71% for ISP-2-DE, 71% for ISP-ECG, 86% for EX-ECG and 71% for EX-RNA. The specificity for CAD was 83% for ISP-2-DE, 33% for ISP-ECG, 50% for EX-ECG and 100% for EX-RNA. In conclusion, the ISP-2-DE test is a safe, easily available and useful method for the assessment of coronary artery disease in elderly patients.
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Fujita et al. (1986) studied this question.
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