Document Detail

Abnormal left ventricular early diastolic filling during dobutamine stress Doppler echocardiography is a sensitive indicator of significant coronary artery disease.
MedLine Citation:
PMID:  7963106     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study was designed to assess changes in Doppler indexes of left ventricular ejection and filling in response to high dose (40 micrograms/kg body weight per min) dobutamine stress and their utility in detection of coronary artery disease compared with that of new wall motion abnormalities. METHODS: Ten patients with a low likelihood of coronary artery disease served as a control group, and 23 patients with documented single-vessel coronary artery disease underwent baseline and peak dobutamine echocardiographic and Doppler studies. RESULTS: In both groups dobutamine induced similar increases in heart rate and systolic blood pressure. During the test, 14 patients had new wall motion abnormalities, 13 had angina, and 7 had electrocardiographic ST segment changes. No markers of ischemia occurred in the control subjects. Dobutamine induced qualitatively similar changes from baseline to peak dobutamine stress in control subjects and patients in peak aortic velocity (46% vs. 42%, p = NS), average aortic acceleration (61% vs. 43%, p = 0.03) and systolic time-velocity integral (7% vs. 2%, p = NS). Dobutamine caused marked increases in control subjects and decreases in patients in peak early filling velocity (E) (33% vs. -22%, p < 0.0001) and average E acceleration (76% vs. -28%, p < 0.0001). The response of Doppler early filling indexes to dobutamine stress was abnormal in all patients. There was no overlap in the percent change from baseline to peak dobutamine stress between control subjects and patients for E and E acceleration. CONCLUSIONS: During dobutamine stress testing, an abnormal response of Doppler indexes of left ventricular early filling is a more sensitive marker of significant single-vessel coronary disease than are new wall motion abnormalities, and it is far superior to the response of Doppler ejection variables as a predictor of coronary artery disease.
E S el-Said; J R Roelandt; P M Fioretti; A J McNeill; T Forster; H Boersma; D T Linker
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  24     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1994-12-16     Completed Date:  1994-12-16     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1618-24     Citation Subset:  AIM; IM    
Thoraxcenter, University Hospital Rotterdam-Dijkzigt, The Netherlands.
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MeSH Terms
Blood Flow Velocity
Coronary Disease / diagnosis,  physiopathology,  ultrasonography*
Dobutamine / diagnostic use*
Echocardiography, Doppler*
Exercise Test
Middle Aged
Myocardial Contraction
Stroke Volume*
Ventricular Dysfunction, Left / physiopathology*
Reg. No./Substance:

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