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Cardiac Response to β-Adrenergic Stimulation Determined by Pressure-Volume Loop Analysis
08:05

Cardiac Response to β-Adrenergic Stimulation Determined by Pressure-Volume Loop Analysis

Published on: May 19, 2021

Hyperdynamic myocardial response to beta-adrenergic stimulation in patients with chest pain and normal coronary

Juraj Madaric1, Jozef Bartunek, Katia Verhamme

  • 1Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium.

Journal of the American College of Cardiology
|October 4, 2005
PubMed

Insights

Abnormal beta-adrenergic stimulation responses may cause chest pain in patients with normal coronary arteries. Dobutamine echocardiography revealed abnormal intraventricular flow velocities in nearly half of patients, which improved with bisoprolol treatment.

Area of Science:

  • Cardiology
  • Physiology
  • Diagnostic Imaging

Background:

  • The underlying causes of angina-like chest pain in patients with normal coronary arteries are not fully understood.
  • Investigating the role of beta-adrenergic stimulation in this patient group is crucial for diagnosis and treatment.

Purpose of the Study:

  • To test the hypothesis that an abnormal response to beta-adrenergic stimulation contributes to chest pain pathophysiology in patients with normal coronary arteries.
  • To evaluate regional wall motion and intraventricular flow velocities (IFV) using dobutamine echocardiography (DE).

Main Methods:

  • Fifty-eight patients with angina-like chest pain and normal coronary angiograms underwent DE.
  • Twenty-two matched healthy individuals served as controls.
  • Abnormal IFV was defined as a dagger-shaped Doppler spectrum ≥3 m/s.

Main Results:

  • No dobutamine-induced regional wall motion abnormalities were observed.
  • Abnormal IFV (≥3 m/s) was detected in 48% of patients with chest pain versus 18% of controls (p < 0.05).
  • Patients with abnormal IFV had higher plasma renin concentration (PRC).
  • Treatment with bisoprolol reduced IFV and angina scores in a subgroup of patients.

Conclusions:

  • An exaggerated myocardial response to beta-adrenergic stimulation is implicated in the mechanisms of chest pain in some patients with normal coronary arteries.
  • Dobutamine echocardiography and assessment of IFV can identify patients with abnormal beta-adrenergic responses.
  • These findings suggest a potential therapeutic target for managing chest pain in this population.
Abstract

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