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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

PROGNOSTIC VALUE OF DOBUTAMINE STRESS ECHOCARDIOGRAPHY IN PATIENTS SCHEDULED FOR VASCULAR SURGERY, 30 MONTHS FOLLOW UP STUDY
Lj. Mangovski, A. Nešković, R. Babić, D. Maraš, M. Mirić and B. Đukanović
Dedinje Cardiovascular Institute, Belgrade, Yugoslavia

The aim of this study was to assess the long-term prognostic value of dobutamine stress echocardiography (DES) for new coronary events in patients who underwent vascular surgery procedures. Methods: We evaluated 50 consecutive patients (pts) scheduled for elective vascular surgery. All pts had EF>30%. Pts with unstable angina were excluded from the study. DES was performed using the high dose dobutamine protocol. Positive DES was determined as new wall motion abnormality or worsening of preexisting wall motion disinergy. According to the outcome of DSE pts were divided into 2 groups: Group 1, pts with positive DES (29/50 pts. 58%) and Group 2 which represented pts with negative DSE (21/50 pts, 42%). All patients were followed for 30 months after vascular procedure. The incidence of cardiac events, fatal and non-fatal myocardial infarction (MI), and need for PTCA and CABG were followed and compared with the results of the DSE test parameters. Results: During follow up period in group 1, 12/29 (41,4%) pts had new coronary events comparing to group 2 without new coronary events (p<0,05). Also, incidence of fatal (1/29, 3.4%) and non-fatal MI (3/29, 10,3%) was higher in group 1. (4/29 vs. 0/21). 4/29 pts (13.8%) from group 1 underwent CABG and 2/29 pts (6.8%) had PTCA. Mean time from positive DSE to new coronary event was 13+/- 8.6 months. Univariate regression analysis shown that ESV peak (p=0,047) and presence of ST depression >2 mm during DSE (p=o,023) are strong predictors of new coronary events. Also, DSE outcome can strongly predict survival of these patients. Conclusion: Positive DSE in patients scheduled for vascular surgery is associated with increased incidence of new coronary events and lower survival during long-term follow-up. Presence of increased ESV and ST depression > 2mm can strongly predict these events.

Drugi kongres kardiologa i angiologa Bosne i Hercegovine
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