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International Angiology 2000 September;19(3):231-236

Copyright © 2001 EDIZIONI MINERVA MEDICA

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


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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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