Influence of gender on the diagnostic and prognostic significance of the dobutamine stress echocardiography for ischemia

  • Dijana Trninić University Clinical Center of the Republic of Srpska, Cardiology Clinic, Banja Luka, Bosnia and Herzegovina
  • Snježana Pejičić Popović University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and Herzegovina
  • Jelena Jovanić University Clinical Center of the Republic of Srpska, Cardiology Clinic, Banja Luka, Bosnia and Herzegovina; University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and Herzegovina
  • Miron Marjanović University Clinical Center of the Republic of Srpska, Cardiology Clinic, Banja Luka, Bosnia and Herzegovina
  • Siniša Kovačević University Clinical Center of the Republic of Srpska, Cardiology Clinic, Banja Luka, Bosnia and Herzegovina
  • Neno Dobrijević University Clinical Center of the Republic of Srpska, Cardiology Clinic, Banja Luka, Bosnia and Herzegovina
  • Aleksandar Milan Lazarević University Clinical Center of the Republic of Srpska, Cardiology Clinic, Banja Luka, Bosnia and Herzegovina; University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and Herzegovina
Keywords: coronary disease;, diagnosis;, echocardiography, stress;, sensitivity and specificity;, sex factors

Abstract


Uvod/Cilj. Kardiovaskularne bolesti su najčešći uzrok mortaliteta i morbiditeta u celom svetu, sa najvećom incidencijom u zemljama sa niskim i srednjim dohotkom. Dobutaminski stres-ehokardiografski (DSE) test ima značajnu ulogu u dijagnostici koronarne arterijske bolesti. Cilj rada bio je da se ispita uticaj pola na tačnost DSE, kao i na prognostički značaj skora indeksa pokretljivosti zidova (wall motion score index – WMSI) leve komore, kao parametra DSE za neželjene kardiovaskularne događaje (NKD). Metode. Prospektivnom, opservacionom studijom koja je rađena na Klinici za kardiovaskularne bolesti Univerzitetskog kliničkog centra Republike Srpske, Bosna i Hercegovina, obuhvaćena su 143 bolesnika koji su zbog sumnje na koronarnu bolest bili podvrgnuti DSE u periodu od 1. januara 2021. do 1. februara 2022. godine. Godinu dana od urađenog DSE testa, uočeni su sledeći NKD: nestabilna angina pektoris, akutni infarkt miokarda, perkutana koronarna intervencija, restenoza u stentu (in-stent restenosis), aortokoronarni bypass, srčana insuficijencija i smrt. Rezultati. Pozitivan DSE test bio je češći kod muškaraca (45%) u odnosu na žene (25%), što je bilo statistički značajno (p < 0,05). Senzitivnost testa kod muškaraca iznosila je 96,0%, a specifičnost 93,9%. Kod žena su i senzitivnost i specifičnost iznosile 86,7%. NKD su bili češći kod muškaraca (43%) nego kod žena (19%) i ta razlika je bila statistički značajna (p < 0,01). Indeks WMSI je kod muškaraca imao senzitivnost 96,0%, a specifičnost 82,4%. Kod žena je WMSI za predviđanje NKD imao senzitivnost 93,3% i specifičnost 90,6%. Zaključak. Naši rezultati su potvrdili uticaj pola na tačnost DSE testa u dijagnostici koronarne arterijske bolesti. Indeks WMSI, kao parametar DSE, identifikovan je kao značajan prognostički faktor za NKD kod oba pola, s tim što je senzitivnost bila viša kod muškaraca, a specifičnost kod žena.

Author Biography

Neno Dobrijević, University Clinical Center of the Republic of Srpska, Cardiology Clinic, Banja Luka, Bosnia and Herzegovina

internista kardiolog

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Published
2024/08/02
Section
Original Paper