[The prognostic value of dobutamine stress echocardiography. A long-term follow-up study]. / Der prognostische Wert der Dobutamin-Stressechokardiographie. Eine Langzeit-Follow-up-Studie.

BACKGROUND AND OBJECTIVE: The prognostic value of dobutamine stress echocardiography in patients with suspected or known coronary heart disease has not exactly been assessed. Purpose of the study was the assessment of the prognostic value of DSE regarding cardiac events, especially in patients with a normal DSE finding. PATIENTS AND METHODS: 316 patients (168 men, 148 women, mean age 61 +/- 10 years), included in this follow-up study, underwent DSE between January 1994 and December 1996 to evaluate clinically suspected or known coronary heart disease. DSE was classified according to resting and stress echocardiography as either "normal-normal (NN)", "normal-ischemic (NI)", "abnormal-normal (AN)", "abnormal-ischemic (AI)" or "inconclusive (C)". Follow-up by telephone took place between June 1997 and April 1998. "Events" were survived myocardial infarction and death. "Interventions" were revascularisation procedures, either percutaneous transluminal coronary angioplasty (PTCA) with or without stenting or aortocoronary bypass surgery. RESULTS: In 161 patients, DSE was NN, NI in 27 patients, AN in 55 patients, AI in 54 patients and C in 19 patients. Mean follow-up duration was 28 months. Events occurred in 23 patients: survived myocardial infarction in 10, death in 13 persons. Interventions were carried out in 50 patients: PTCA with or without stenting in 19, aortocoronary bypass surgery in 31 persons. The event rate was significantly lower in patients with DSE classified as NN (P = 0.03 by log-rank) than in other groups. The intervention rate was significantly lower in the NN-group (P = 0.0001 by log-rank) than in the other groups, too. CONCLUSION: Patients with a normal rest echocardiography and DSE had a good prognosis in a long-term follow-up study.