Use of dobutamine stress echocardiography for risk assessment before noncardiac surgery.

Preoperative cardiac risk stratification has been traditionally performed using clinical variables indicative of increased cardiac risk, more recently dipyridamole-thalium imaging has been used with variable success. Several well-designed clinical studies have now shown that DSE is a feasible, safe, and useful modality for cardiac risk stratification before surgical procedures; its accuracy is comparable to nuclear perfusion testing. DSE has the additional advantages of having a relatively lower cost and providing additional information regarding ventricular and valvular function.