小剂量多巴酚丁胺-异舒吉超声心动图负荷试验检测冠心病人存活心肌

目的探讨异舒吉(Isoket)对小剂量多巴酚丁胺超声负荷试验(LDDSE)的影响。方法研究对象39例依据冠脉造影的结果分为三组:对照组(CON)12例、冠心病1组(CAD1)15例和冠心病2组(CAD2)12例,其中CAD2行LDDSE Isoket,其余两组行LDDSE,以冠脉介入性治疗(PCI)后室壁运动改善的结果作为评价LDDSE的标准。结果Isoket可以明显增加心率,降低收缩压,但对舒张压影响轻微。CAD1组室壁运动双相反应的发生率为62.50%,存活心肌检出敏感性为61%,特异性为76%;CAD2组室壁运动双相反应的发生率为72.20%,存活心肌检出敏感性为82%,特异性为88%;CAD2组存活心肌的检出率和敏感性明显高于CAD1组。结论Isoket可提高LDDSE存活心肌检出率。

Low-dose dobutamine-Isoket stress echocardiography detecting hibernating myocardium in patients with coronary artery disease

Objective:To observe the effect of isoket on low-dose dobutamine stress echocardiography(LDDSE).Methods:39 patients were divided into 3 groups according to the results of quantitative coronary angiography(QCA):the control group(CON) including 12 patiens,the coronary artery disease group 1(CAD1) including 15 patients,and the coronary artery disease group 2(CAD2) including 12 patients.Among the three group,the LDDSE isoket was done in CAD2,while the LDDSE was done in the other two groups.The improvement of segments of left ventricular after percutaneous transluminal intervention(PCI) was looked as the standard evaluating LDDSE.Results: Isoket could increase heart rate and decrease SBP,but could hardly affect DBP.The rate of biphysic response was 62.50% in group CAD1,and the sensitivity of detecting viable myocardium was 61%,while the specificity was 76%.In group CAD2,the rate of biphysic response was 72.20%,and the sensitivity of detecting viable myocardium was 82%,while the specificity was 88%.The rate detecting viable myocardium and sensitivity was improved significantly in group CAD2.Conclusion: LDDSE combined with isoket was benefit for detecting viable myocardium.