Comparative ability of dobutamine and exercise stress in inducing myocardial ischaemia in active patients.
Key result
Dobutamine stress induced electrocardiographic evidence of ischaemia less frequently than exercise stress (32% vs 77%, P<0.01) in patients with significant coronary disease.
Why the study?
Does dobutamine stress testing compare to exercise stress testing in inducing myocardial ischaemia and perfusion heterogeneity in active patients without previous myocardial infarction?
Population
86 active patients without previous myocardial infarction
Comparison
Dobutamine stress testing with… vs Exercise stress testing with…
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
Dobutamine stress may underestimate ECG ischaemia; leaves open its diagnostic role versus exercise in active CAD patients.
Study Design
Type
Cross-Sectional (n=86)
Structured PICO
Does dobutamine stress testing compare to exercise stress testing in inducing myocardial ischaemia and perfusion heterogeneity in active patients without previous myocardial infarction?
P
Population
86 active patients without previous myocardial infarction who underwent both dobutamine and exercise stress protocols.
E
Exposure
Dobutamine stress testing with electrocardiography, digitised echocardiography, and Tc-99m MIBI SPECT
C
Comparator
Exercise stress testing with electrocardiography, digitised echocardiography, and Tc-99m MIBI SPECT
O
Outcome
Induction of myocardial ischaemia and perfusion heterogeneity (defined as ST segment depression of >= 0.1 mV, a resting or stress induced perfusion defect, or a resting or stress induced wall motion abnormality)surrogate
Main Result
Absolute Event Rate: 32% vs 77%
p-value: p=<0.01
Exercise stress is superior to dobutamine stress for inducing electrocardiographic ischemia and wall motion abnormalities in active patients, largely because dobutamine tests are frequently submaximal in routine clinical practice.
Limitations
- Antianginal treatment and inability to complete the stress protocol are frequent and compromise the capacity of dobutamine stress to induce ischaemia.
Cite This Study
Marwick et al. (1994) conducted a cross-sectional in Active patients without previous myocardial infarction (n=86). Dobutamine stress test vs. Exercise stress test was evaluated on Electrocardiographic evidence of ischaemia in patients with significant coronary disease (p=<0.01). Dobutamine stress induced electrocardiographic evidence of ischaemia less frequently than exercise stress (32% vs 77%, P<0.01) in patients with significant coronary disease.