Staff Members - Benha University
Accuracy of Dobutamine Stress Echocardiography as A Predictor for Major Adverse Cardiovascular Events in Patients with Reduced Exercise Capacity Undergoing Major Non-Cardiac Surgery
• 2020
Publication Information
Authors
Mohamed Abdel Shafy Tabl* and Ahmad Youssif Nammour
Keywords
Dobutamine stress echocardiography, Major surgeries, Risk
stratifications
Journal
Not Available
Publisher
Not Available
Volume
Not Available
Issue
Not Available
Pages
Not Available
publication.type
International
Paper Link
Not Available
Supplementary Materials
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Abstract
Background: Before major non cardiac surgeries, non-invasive functional testing widely indicated for evaluating patients
with reduced exercise capacity.
Aim: To assess the accuracy of dobutamine stress echocardiography (DSE) for risk stratification prior to major non‐cardiac
surgeries.
Methods: eighty patients hospitalized for major non-cardiac surgeries underwent DSE and were reviewed to determine major
adverse cardiac events (MACE) up to 30 days post‐discharge.
Results: Out of 80 DSE performed for preoperative risk stratification, 12.5% were positive and 87.5% were negative. Postoperative
MACE in the DSE +ve group was 36% compared to 4% in the DSE‐ve group (OR = 14.8889, p = 0.002). Based on
the MACE rates, the overall sensitivity of DSE was 56%, specificity was 90%, and positive predictive value (PPV) was only
36% while negative predictive value (NPV) was 95%. The admission for ICU and total days of hospital stay post surgery was
comparable in both groups (p = 0.177).
Conclusion: DSE for preoperative risk stratification had a high clinical utility in patients undergoing major non‐cardiac
surgery. In particular, a normal DSE had a high negative predictive value for post-operative MACE up to 30 days post
discharge. Positive DSE did not correlate with the admission for ICU or total days of hospital stay post major non cardiac
surgery.
with reduced exercise capacity.
Aim: To assess the accuracy of dobutamine stress echocardiography (DSE) for risk stratification prior to major non‐cardiac
surgeries.
Methods: eighty patients hospitalized for major non-cardiac surgeries underwent DSE and were reviewed to determine major
adverse cardiac events (MACE) up to 30 days post‐discharge.
Results: Out of 80 DSE performed for preoperative risk stratification, 12.5% were positive and 87.5% were negative. Postoperative
MACE in the DSE +ve group was 36% compared to 4% in the DSE‐ve group (OR = 14.8889, p = 0.002). Based on
the MACE rates, the overall sensitivity of DSE was 56%, specificity was 90%, and positive predictive value (PPV) was only
36% while negative predictive value (NPV) was 95%. The admission for ICU and total days of hospital stay post surgery was
comparable in both groups (p = 0.177).
Conclusion: DSE for preoperative risk stratification had a high clinical utility in patients undergoing major non‐cardiac
surgery. In particular, a normal DSE had a high negative predictive value for post-operative MACE up to 30 days post
discharge. Positive DSE did not correlate with the admission for ICU or total days of hospital stay post major non cardiac
surgery.