Dipyridamol with pacing and dobutamin with pacing as methods of induction of myocardial ischemia in stress-echocardiography

New methods of induction of ischemia of myocardium (dipyridamol with pacing and dobutamin with pacing) allow toovercome restrictions of traditional stress ñ echocardiography. Aim: to compare feasibility, accuracy and safety of dipyridamolwith pacing vs. dobutamin with pacing. Design: case ñ control study of two identical groups of patients (n=76) with notwidespread angiographic stenoses of coronary arteries. Methods: trasesophageal atrial pacing after infusion of 20micrograms/kg of Dobutamin was carried out in the first group. Trasesophageal atrial pacing after infusion of 0,84milligrams/kg of Dipyridamole was carried out in the second group. Results: The sensitivity of dobutamin with pacingstress-echocardiography in detection of CAD was 89% and specificity ñ 96%, AUC in ROC ñ curves ñ 0,92. Positive predicativevalue was 92%, negative predicative value ñ 93% (prevalence of CAD in first group ñ 36%). Feasibility was 97%, twocomplications were registered. The sensitivity of dipyridamol with pacing stress-echocardiography in detection of CADwas 91% and specificity ñ 97%, AUC in ROC ñ curves ñ 0,94. Positive predicative value was 97%, negative predicative valueñ 88% (prevalence of CAD in second group ñ 60%, they both fell under Bayes' theorem). Feasibility was 100%, onecomplication of stress was registered. Conclusion: Dipyridamol with pacing stress-echocardiography is more accurate,and pharmacological agent is less uncomfortable for patients.