Prognostic value of dobutamine stress echocardiography: A South African experience

André P. Dippenaar, Lariska Scherman, Amanda Espach, Anja De Lange, Louiso du Pisanie, Brandon Franckeiss, Paul A. Brink, Pieter van der Bijl

Abstract

Background: Dobutamine stress echocardiography (DSE) is a well-established modality for the diagnosis and risk-stratification of coronary artery disease, but no prognostic data have been reported from Southern Africa.
Objectives: We investigated the prognostic utility of a South African DSE programme and compared the results to larger, international series.
Methods: All patients undergoing DSE from 2019 to 2023 at a single South African centre were included. A new wall motion abnormality (≥ 2 segments) signified inducible ischaemia.
Results: 166 patients (median age 65 ± 11 years, 69% male) were analysed. 52 patients (31%) had diabetes mellitus, 159 (93%) had dyslipidaemia and 35 (21%) were smokers. 48 (29%) patients had received previous percutaneous revascularization and 10 (6%) coronary artery bypass surgery. During a median follow-up of 36 ± 7 months, 33 (20%) patients died or underwent coronary artery revascularization. Individuals with demonstrable, inducible ischaemia experienced a higher rate of all-cause mortality or revascularization during follow-up.
Conclusion: The prognostic value of a South African DSE programme for all-cause mortality and revascularization was demonstrated for the first time. Data are aligned with large, international series with comparable follow-up time.