P849Prevalence of coronary artery spasm during dobutamine stress echocardiography


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Abstract

Background: Previous care reports have suggested that dobutamine stress echocardiography may induce coronary artery spasm. The aim of this study was to assess the prevalence of coronary artery spasm during dobutamine stress echocardiography.Methods: Over a nine-year period (from November 2001 to October 2010), we reviewed all patients (n = 2,224) referred for dobutamine stress echocardiography. Criteria for selection included patients aged >18 years and with dobutamine stress echocardiography. We systematically analyzed all ECG performed during dobutamine stress echocardiography, allowing to detect ST elevation during the examination. All patients with ST elevation underwent a coronary angiography.Results. A dobutamine stress echocardiography was performed in 2,224 patients. In 20 patients, a ST elevation was observed (always in inferior leads) and all these patients underwent an urgent coronary angiography. In 13 patients (65%), a significant coronary stenosis was observed: ST elevation was observed in case of critical coronary stenosis in 6 patients and in case of chronic coronary occlusion in 7 patients. Finally, 7 patients (35% of patients presenting with ST elevation during dobutamine stress echocardiography; 6 men, mean age: 67 ± 11 years) had no significant coronary stenosis. The prevalence of coronary artery spasm during dobutamine stress echocardiography was 0.3%. Coronary artery spasm during coronary angiography was induced with methergin testing or dobutamine perfusion.Conclusion. Coronary artery spasm during dobutamine stress echocardiography is rare but may occur. Its prevalence is estimated to 0.3%. Physicians should aware of its presence in dobutamine stress echocardiography.

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