Dobutamine stress radionuclide ventriculography for the detection of coronary artery disease

Thirty patients were prospectively studied to assess the value of radionuclide ventriculography (RNV) during step-wise dobutamine infusion for the detection of coronary artery disease (CAD). Radionuclide ventriculography was performed under basal conditions and during dobutamine infusion from 10 to a maximum of 40 μg kg-1 min-1. The test response was considered positive if the ejection fraction (EF) decreased by more than 5% or if segmental contraction abnormalities developed. In nine of 11 patients without CAD, EF increased more than 5% of the rest value and the left ventricular wall motion was normal in 10 of them during dobutamine infusion. In 18 of 19 patients with CAD, new wall motion abnormalities (WMA) were identified in segments corresponding to the arterial lesions diagnosed by angiography. Ejection fraction response was significantly different in normal subjects and in patients with CAD: 11 ± 5.9% versus 1.9 ± 9.5%. However, abnormal EF response was found in seven of 19 CAD patients and development of new WMA was found to be a more sensitive and specific parameter then EF response for dobutamine RNV. It is concluded that dobutamine RNV is an accurate, widely available and cost-effective test for detecting CAD, especially in patients unable to exercise. (Author)