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[The echo-dobutamine pharmacological stress test in ischemic cardiopathy]
R Caballero1, S Solorio, E Badui
1División de Cardiología, Hospital de Especialidades, Centro Médico La Raza, IMSS, México, D.F.
Insights
The Echo-Dobutamine stress test is a safe and effective method for evaluating patients with ischemic heart disease. This pharmacologic stress test demonstrated good sensitivity and specificity without severe complications.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Ischemic heart disease diagnosis often relies on stress testing.
- Pharmacologic stress echocardiography offers an alternative when exercise stress is not feasible.
Purpose of the Study:
- To evaluate the sensitivity, specificity, and safety of the Echo-Dobutamine stress test.
- To assess the diagnostic performance of this pharmacologic stress test in patients with suspected ischemic heart disease.
Main Methods:
- 30 patients with ischemic heart disease underwent Echo-Dobutamine stress testing.
- Intravenous dobutamine was administered incrementally (2.5-40 µg/kg/min) with continuous ECG and blood pressure monitoring.
- Left ventricular segmental motility was assessed via 2D echocardiography at each dobutamine dose increment.
Main Results:
- The test was well-tolerated with no severe complications or arrhythmias reported.
- Heart rate and blood pressure increased significantly during the test (p < 0.001).
- Basal ejection fraction by echo correlated well with cardiac catheterization (p=NS).
Conclusions:
- The Echo-Dobutamine stress test is a safe procedure for evaluating patients with ischemic heart disease.
- The study supports the utility of this pharmacologic stress test in assessing cardiac function and detecting ischemia.
Abstract:
We report our experience with Echo-Dobutamine stress test. In order to evaluate the sensitivity, specificity and the safety, of the pharmacologic echo-dobutamine stress test, we studied 30 patients with ischemic heart disease based on clinical history, 2D echocardiogram, standard exercise stress test and cardiac catheterization. The test was started under continuous videotape of the segmental left ventricular motility on the conventional views. Dobutamine was administer intravenously 2.5 to 40 micrograms/kg/min every 3 minutes, the mean higher dobutamine dose was 19 +/- 14.3 micrograms/kg/min, having a continuous electrocardiographic monitoring of the heart rate as well as blood pressure. The myocardial motility was recorded with each increment in the dobutamine dose. Among the cases, 22 were males and 8 females with an average age of 55 +/- 9 years. Twenty two patients had history of remote myocardial infarction and were asymptomatic at the moment of the test; 8, who had angina pectoris were on a functional class I-II of the CCS. The mean basal ejection fraction was 62.6 +/- 11.7% by echo vs 64.4 +/- 16.8% obtained by cardiac catheterization (p no significant). There were no arrhythmias in any case. The heart rate increased from 68.7 +/- 10.1 to 85.5 +/- 15.7 beats per minute (p < 0.001). The systolic B/P was increased from a mean of 124 +/- 14.5 to 138.3 +/- 14.4 mmHg (p < 0.0005) while the diastolic pressure varied from 82.3 +/- 8.2 to 90.8 +/- 9.6 mmHg (p < 0.001). There were no severe complications.(ABSTRACT TRUNCATED AT 250 WORDS)