Monday, January 30, 2006

New research could help diagnose heart disease in women

A team at the St. Louis School of Medicine, has new data on the use of dobutamine stress echocardiography – a test that enables doctors to better predict future heart disease.

Researchers studied 421 women between the ages of 49 and 75, an age range historically mis- and under-diagnosed for heart disease.“Our research is extremely important to women in this age group." By detecting problems earlier, we can help prevent heart attack or death and extend these women’s lives.”

Dobutamine stress echocardiography tests are ultrasound heart scans in which patients are injected with a drug that makes the heart beat faster to determine if they have abnormalities of the heart wall. No exercise is involved. Traditional echocardiography tests are performed without the aid of drugs by having patients run on a treadmill to increase their heart rate.

Researchers followed the patients for two years and found that women who tested positive on the stress test were more likely to experience cardiac events, heart attacks, and even heart failure and death: 18% had had a heart attack, and 5% had died of one.

In a second study researchers studied 1,404 patients who underwent preoperative dobutamine stress echocardiography to determine if they had ischemia. “In the medical community, it is common to believe the heart rate must be at least 85 percent of the maximal heart rate,” Dolan says. “However, we found that a negative dobutamine stress test without abnormalities has a strong predictive value whether the heart rate is maximal or not.”

The implications for such results are that doctors ordering stress echocardiography can have more confidence in tests returning negative for ischemia than they had previously thought, effectively broadening the parameters normally used to rule out ischemia – meaning some patients will not have to undergo additional heart scans to rule out the condition before they undergo surgery. This is good news for individuals who cannot achieve a maximal heart rate on a treadmill stress test for reasons such as muscle discomfort, arthritis, shortness of breath from lung disease, etc.

Echocardiography combined with exercise stress testing is a well-tolerated and valuable procedure for noninvasive evaluation of coronary artery disease. The sensitivity and specificity is comparable to that of nuclear perfusion imaging (thallium stress testing.)

It's also good to see more cardiac research being performed on women. Friday, National Wear Red Day, is fast approaching. Learn more about it.

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