TITLE:
Place of Exercise Echocardiography in Stable Coronary Artery Disease in Sub-Saharan Africa: A Series in Senegal
AUTHORS:
F. Aw, M. B. Ndiaye, C. M. B. M. Diop, S. A. Sarr, J. S. Mingou, M. T. Diouf, M. M. Ka, M. Ndiaye, Hariniaina Ravaoavy, M. Bodian, A. A. Ngaïdé, M. Dioum, M. Leye, A. Mbaye, A. D. Kane, A. Kane, M. Diao, S. A. Ba
KEYWORDS:
Exercise Echocardiography, Coronary Artery Disease
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.10 No.1,
January
16,
2020
ABSTRACT: Introduction: Exercise echocardiography is a non-invasive technique that occupies a special place for the
detection of stable coronary disease. The main objective of this study was to
report our experience and assess our practice in the diagnosis of stable
coronaryartery disease. Methodology: We conducted a
retrospective study, descriptive over a period of 34 months, from December 1,
2016 to September 30, 2019. All the patients received during the study period
for stress echocardiography as part of a suspicion of stable coronary artery
disease were included. A total of 100 examinations were completed during the
study period. Results: Ninety (90) exams were
studied. There were 56 men or a sex-ratio of 1.64. The mean age was of 57.3 ± 10 years.
Hypertension (31 patients or 62%) was the most frequent risk factor. Typical
chest pain was noticed in 45 patients (52.3%). The pre-test
probability was intermediate in 77 patients (89.5%). Echocardiography at rest
was normal in 86 patients (95.6%). A total of 62 tests were negative (69%) and
02 (2.2%) were non-contributory. Ten tests (10) of 26 electrical
positive tests were associated with segmental kinetics disorders. In the 10
patients who had exercise kinetic disorders, 08 had coronary angiography. It
was normal in 04 of them. The positive predictive value of exercise echography
was 50% in our study. In a patient with a negative exercise echocardiography with
a high clinical probability of coronary disease, the coronary angiography
showed a two-vessel impairment with an intermediate lesion of Cx2 and an intermediate lesion
of RCA2. It thus constitutes a false negative. Sensitivity was 80% in our
study. We noticed an incident like non-sustained ventricular tachycardia. Conclusion: Exercise
echocardiography is a safe and reliable examination for the diagnosis of stable
coronary artery disease. A good selection of patients based on the clinical
probability of coronary ischemia should improve our sensitivity. This is even
more important in sub-Saharan Africa, where access to coronary angiography is
limited.