Related Experiment Video
Updated: Mar 28, 2026
Author Spotlight: Enhancing Graft Viability Assessment Through Quantitative Metrics and Innovative Reservoir Systems
Published on: August 2, 2024
Dobutamine stress echocardiography after cardiac transplantation: implications of donor-recipient age difference
Patrick H Gibson1, Fernando Riesgo2, Jonathan B Choy2
1Royal Infirmary of Edinburgh , 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA , UK.
Insights
Donor age impacts cardiac transplant patients' ability to reach target heart rate during dobutamine stress echocardiography. Older donors were associated with a lower likelihood of achieving adequate stress levels, affecting diagnostic accuracy.
Area of Science:
- Cardiology
- Transplantation Medicine
- Diagnostic Imaging
Background:
- Dobutamine stress echocardiography (DSE) is crucial for diagnosing allograft vasculopathy post-cardiac transplant.
- Achieving target heart rate (HR) during DSE is essential for accurate assessment.
- The influence of donor-recipient age difference on DSE outcomes is not well-established.
Purpose of the Study:
- To investigate the effect of donor-recipient age difference on achieving target HR during DSE.
- To determine if donor age influences dobutamine dosage requirements and HR achievement.
Main Methods:
- Retrospective review of 61 cardiac transplant patients undergoing DSE over 3 years.
- Target HR defined as 85% of maximum predicted HR (220 - patient age).
- Analysis of patient/donor demographics, dobutamine dosage, and HR achieved.
Main Results:
- Only 61% of patients achieved their target HR.
- Patients with older donors required higher dobutamine doses (median 50 vs 30 mcg/kg/min).
- Older donors were associated with lower percentage target HR achieved (93% vs 101%) and a significantly lower likelihood of achieving target HR (18% vs 67%).
Conclusions:
- Donor-recipient age difference is a significant factor affecting the ability to achieve target HR during DSE.
- Consideration of donor age may be necessary when interpreting DSE results in patients unable to reach adequate stress levels.
- This finding has implications for the diagnostic utility of DSE in cardiac transplant follow-up.
Abstract:
Dobutamine stress echocardiography (DSE) is widely used during follow-up after cardiac transplant for the diagnosis of allograft vasculopathy. We investigated the effect of donor-recipient age difference on the ability to reach target heart rate (HR) during DSE. All cardiac transplant patients who were undergoing DSE over a 3-year period in a single institution were reviewed. Target HR was specified as 85%×(220 - patient age). Further patient and donor demographics were obtained from the local transplant database. 61 patients (45 male, 55±12 years) were stressed with a median dose of 40 mcg/kg per min dobutamine. Only 37 patients (61%) achieved target HR. Donor hearts were mostly younger (mean 41±14 years, P<0.001), with only 11 patients (18%) having donors who were older than they were. Patients with older donors required higher doses of dobutamine (median 50 vs 30 mcg/kg per min, P<0.001) but achieved a lower percentage target HR (mean 93% vs 101%, P=0.003) than those with younger donors did. Patients with older donors were less likely to achieve target HR (18% vs 67%, P=0.003). In conclusion, donor-recipient age difference affects the likelihood of achieving target HR and should be considered when a patient is consistently unable to achieve 'adequate' stress according to the patient's age.
More Related Videos
08:21Functional Assessment of the Donor Heart During Ex Situ Perfusion: Insights from Pressure-Volume Loops and Surface Echocardiography
Published on: October 11, 2022
12:12Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice
Published on: February 14, 2017
