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Dobutamine-induced ST-segment elevation in patients without myocardial infarction
M Previtali1, R Fetiveau, L Lanzarini
1Department of Cardiology, IRCCS Policlinico San Matteo, University of Pavia, Italy. previt@tin.it
The American Journal of Cardiology
|January 5, 1999
Summary
ST-segment elevation during dobutamine stress echocardiography in patients without prior myocardial infarction often indicates significant coronary artery stenosis or vasospasm, leading to temporary severe myocardial dysfunction.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Clinical Medicine
Background:
- Dobutamine stress echocardiography (DSE) is a common tool for diagnosing coronary artery disease.
- ST-segment elevation during DSE in patients without prior myocardial infarction is an uncommon but significant finding.
Purpose of the Study:
- To investigate the underlying mechanisms and clinical significance of ST-segment elevation during DSE in patients with no history of myocardial infarction.
Main Methods:
- Retrospective analysis of 372 patients undergoing DSE.
- Correlation of ST-segment elevation with coronary angiography findings and echocardiographic assessment of regional myocardial function.
Main Results:
- ST-segment elevation occurred in 5% (20/372) of patients without prior myocardial infarction.
- This was associated with transient severe asynergy in the corresponding myocardial region.
- In most cases (17/19), ST-segment elevation correlated with critical coronary artery stenosis; in others (2/19), coronary vasospasm was implicated.
Conclusions:
- ST-segment elevation during DSE in this population is frequently linked to significant coronary artery disease.
- Coronary vasospasm should also be considered as a potential cause.
- These findings highlight the importance of further investigation when ST-segment elevation occurs during DSE.