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

Dijana Trninić; Snježana Pejičić Popović; Jelena  Jovanić; Miron Marjanović; Siniša Kovačević; Neno Dobrijević; Aleksandar Milan Lazarević

doi:10.2298/VSP231221042T

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

DOI: https://doi.org/10.2298/VSP231221042T

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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