Contribution of Dobutamine Stress Echocardiography in the Management of Advanced Ischemic and Valvular Heart Diseases in Senegal

Background: Stress echocardiography is the combination of 2D echocardiography with a physical, pharmacological, or electrical stress. It is a cornerstone in the evaluation of patients with coronary artery disease. In contrast, valvular heart disease is usually considered static and its management relies upon resting evaluation only. Methods: It consisted of transversal and descriptive study of the indications and outcomes of Dobutamine Stress Echocardiography (DSE) that have been performed at the University Hospital of Fann in Dakar, Senegal, between November 2015 and December 2016. Results: 152 patients were enrolled in the study. There were 54.60% of females; the mean age was 61.07 (± 10.19) years old ranging from 20 to 80 years old. The indications for DSE included myocardial Contractile Reserve (CR) in 85%, myocardial viability in 8% and myocardial ischemia in 7 %. The 2D radial strain echocardiography was normal in 82.9% and decreased in 17.1 %. The CR assessment (11 patients) was positive in 45.45 % and negative in 54.55 %. The myocardial viability (12 patients): it was positive in 33.34 % and negative in 66.66 %. The myocardial ischemia: it was positive in 20.93% and negative in 79.06 %. 32.9 % presented minor side effects. Conclusion: It is possible to perform DSE in a setting of low income country such us Senegal. This exam is affordable and useful for better management of ischemic and valvular heart diseases in our context. Another study in our region that involves more patients may consolidate these findings. Keywords: Dobutamine Stress Echocardiogram; Strain echocardiography; Ischemic Heart; Heart Valve disease; Senega