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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2000 September;19(3):231-236

lingua: Inglese

The value of dipyridamole thallium scintigraphy and dobutamine stress echocardiography as predictors of cardiac complications following reconstruction of the abdominal aorta

Lacroix H., Herregods M. C. *, Ector H. *, Vandeplas A. *, Nevelsteen A., Suy R.

From the Depart­ment of Vas­cu­lar Sur­gery and * Depart­ment of Car­di­ol­o­gy, Uni­ver­sity Hos­pi­tal, Leu­ven, Bel­gium


Back­ground. The aim of this study was to eval­u­ate the abil­ity of dip­y­rid­a­mole thal­li­um scin­tig­ra­phy and dobu­ta­mine ­stress ech­o­car­di­og­ra­phy to pre­dict car­diac com­pli­ca­tions fol­low­ing elec­tive recon­struc­tion of the abdom­i­nal aorta in ­patients with a ­stable preoper­a­tive car­diac con­di­tion and to com­pare this with infor­ma­tion ­obtained from the med­i­cal his­to­ry, ECG and rest­ing ech­o­car­di­og­ra­phy alone.
Meth­ods. This eval­u­a­tion was per­formed from Jan­u­ary 1993 until Decem­ber 1995 as part of a pros­pec­tive, ran­dom­ised study in 200 ­patients, with a mean age of 65 (5% women). Dip­y­rid­a­mole thal­li­um scin­tig­ra­phy was per­formed on 195 ­patients and dobu­ta­mine ­stress ech­o­car­di­og­ra­phy was added to the pro­to­col in the last 83 ­patients. Car­diac com­pli­ca­tions were ­defined ­before the start of the study.
­Results. In the postoper­a­tive peri­od 62 car­diac com­pli­ca­tions ­occurred (31%). In ­patients clin­i­cal­ly sus­pect­ed of hav­ing cor­o­nary ­artery dis­ease the inci­dence of com­pli­ca­tions was 40% (51/126), com­pared to 15% (11/74) when no cor­o­nary pathol­o­gy was sus­pect­ed (p<0.001). When rever­sible ­defects were ­present on dip­y­rid­a­mole thal­li­um scin­tig­ra­phy the inci­dence of com­pli­ca­tions was 36% (20/55), com­pared to 29% (41/140) when no rever­sible ­defects had been found (NS). Dobu­ta­mine ­stress ech­o­car­di­og­ra­phy was impos­sible or con­tra­in­di­cat­ed in 21 ­patients. In the remain­ing ­patients the inci­dence of com­pli­ca­tions was 71% (5/7) when new region­al wall ­motion abnor­mal­ities were found, com­pared to 16% (9/55) when such abnor­mal­ities had not been detect­ed (p<0.005).
Con­clu­sions. These data sug­gest that car­diac com­pli­ca­tions fol­low­ing recon­struc­tion of the abdom­i­nal aorta in ­patients with a ­stable car­diac con­di­tion are best pre­dict­ed by dobu­ta­mine ­stress ech­o­car­di­og­ra­phy. Dip­y­rid­a­mole thal­li­um scin­tig­ra­phy, how­ev­er, does not seem to be use­ful in this ­respect.

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