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Cardiovascular effects of dobutamine stress testing in healthy women
P Blomstrand1, O Thulesius, B Wranne
1Department of Clinical Physiology, Linköping Heart Centre, University Hospital, Sweden.
Insights
This study examined dobutamine
Area of Science:
- Cardiovascular Physiology
- Diagnostic Imaging
Background:
- Dobutamine echocardiography is vital for diagnosing coronary artery disease.
- Limited data exists on hemodynamic responses in healthy individuals during this test.
- The cause of hypotension during dobutamine stress testing remains unclear.
Purpose of the Study:
- To investigate the hemodynamic response to dobutamine infusion in healthy women.
- To characterize circulatory changes in women without cardiovascular disease.
Main Methods:
- Eleven healthy women (age 53-71) underwent intravenous dobutamine infusion.
- Doppler echocardiography and venous occlusion plethysmography were used.
- A standardized protocol with increasing dobutamine doses was followed.
Main Results:
- Cardiac output increased by 93%, heart rate by 68%, and stroke volume by 15%.
- Peripheral vascular resistance decreased by approximately 50%, while diastolic blood pressure dropped by 21%.
- Older women (>65 years) showed blunted responses compared to younger counterparts.
Conclusions:
- Dobutamine causes significant circulatory changes in healthy women, primarily increased cardiac output and decreased vascular resistance.
- Hypotension is infrequent, but left ventricular outflow obstruction can occur.
- Age influences the hemodynamic response to dobutamine stress testing.
Abstract:
Dobutamine echocardiography is frequently used for detection of coronary artery disease. The circulatory response in patients is known to some extent, but studies in normals are lacking. Hypotensive response during the test is a common side effect, the cause of which is unclear. The aim of this study was, therefore, to investigate the hemodynamic response to dobutamine in women without cardiovascular disease and interfering medications. Eleven healthy women, age 53-71 years, were investigated with Doppler echocardiography and venous occlusion plethysmography during intravenous infusion of increasing doses of dobutamine according to a standardized protocol. An average peak dose of 22 +/- 7.5 micrograms kg-1 min-1 was administered. Cardiac output increased by 93%, heart rate by 68%, and stroke volume by 15%, while peripheral vascular resistance decreased by approximately 50%. Systolic blood pressure remained unchanged and diastolic blood pressure decreased by 21%. One subject demonstrated a decreased systolic blood pressure exceeding 10 mmHg. Outflow obstruction from the left ventricle was seen in two subjects, one of whom had a slight decrease of 10 mmHg in systolic blood pressure. Subjects > 65 years demonstrated a less pronounced increase in heart rate, cardiac output, and decrease in peripheral vascular resistance compared with those < 65 years.