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SAFETY OF STRESS ECHOCARDIOGRAPHY. THE RESULTS OF THE INTERNATIONAL STRESS ECHO COMPLICATION REGISTRY
Author(s) -
Lowenstein J.,
Varga A.,
Rodriguez G.M.A.,
Picano. E.
Publication year - 2004
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.0742-2822.2004.t01-13-20040211.x
Subject(s) - dipyridamole , medicine , stress echocardiography , dobutamine , echo (communications protocol) , cardiology , complication , anesthesia , hemodynamics , coronary artery disease , computer network , computer science
Background: The safety of any diagnostic test is a major issue in deciding its practicability and cost‐effectiveness. Aim: To evaluate the safety of various stress echo modalities in the “real life” an international stress echo complication registry was started. Methods: Up to January 2001, a simple written questionnaire was distributed to 300 echo laboratories known to perform stress echo. Of these 300, 71 echo laboratories were “responders” and reported on 85,997 examinations. Results: Exercise was used in 26,295, dobutamine in 35,103, and dipyridamole in 24,599 cases. Life‐threatening events occurred in 86 patients: during exercise in 4 patients (event rate: 1/6,574), during dobutamine infusion (low dose for viability and/or high dose for ischemia) in 63 patients (event rate 1/557), and during dipyridamole stress test in 19 patients (event rate 1/1,294). Of the 86 patients with complications, 5 died during dobutamine stress test (ventricular fibrillation n=2 and cardiac rupture n = 3), and 1 following a dipyridamole test (uncontrollable hypotension). Conclusion: Stress echocardiography is a safe method in the “real life,” as well, but dreadful complications may occur. Possibly due to preselection criteria, exercise seems safer than pharmacological stress and dipyridamole safer than dobutamine.