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[Dobutamine-related coronary spasm among patients with false positive dobutamine stress echocardiography: Prevalence

F Aboukhoudir1, I Aboukhoudir2, M Pansieri2

  • 1Service de cardiologie, centre hospitalier d'Avignon, 84000 Avignon, France; EA4278, laboratoire de pharm écologie cardiovasculaire, Avignon université, 84000 Avignon, France.

Annales De Cardiologie Et D'Angeiologie
|October 27, 2015
PubMed

Insights

Dobutamine stress echocardiography can cause coronary vasospasm in patients with false-positive results. Dyslipidemia and smoking are key predictors of this spasm, necessitating further investigation beyond standard coronary artery disease detection.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Pharmacology

Context:

  • Dobutamine stress echocardiography (DSE) is a common, exercise-independent method for detecting coronary artery disease (CAD) and myocardial ischemia.
  • However, DSE can occasionally induce coronary vasospasm, leading to misinterpretation of results.
  • This study focuses on patients with false-positive DSE results in the absence of known CAD.

Purpose:

  • To determine the prevalence of dobutamine-induced coronary vasospasm in patients with false-positive DSE results.
  • To identify predictors of dobutamine-related coronary spasm in this patient group.

Summary:

  • A prospective study of 3,952 patients undergoing DSE identified 29 cases of DSE-related vasospasm among those with false-positive results.
  • Patients experiencing spasm were more likely to be active smokers and have dyslipidemia.
  • Multivariate analysis confirmed dyslipidemia (HR=10.7) and active smoking (HR=6.1) as independent predictors of spasm.

Impact:

  • Dobutamine-related coronary spasm occurs in a significant subset of patients with false-positive DSE results.
  • These findings highlight the importance of ruling out vasospasm in cases of apparent false-positive DSE.
  • Identifying dyslipidemia and smoking as predictors can improve diagnostic accuracy and patient management.
Abstract

Keywords:
Coronary spasmDobutamine stress echocardiographySpasme coronaireÉchocardiographie à la dobutamine

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