Document Detail

Coronary artery spasm and dobutamine stress echocardiography.
MedLine Citation:
PMID:  19202147     Owner:  NLM     Status:  MEDLINE    
AIMS: The aim of this article was to assess whether abnormal dobutamine stress echocardiography (DSE) can be due to a dobutamine-induced coronary spasm in patients with angiographically documented vasospastic coronary arteries. METHODS AND RESULTS: Between January 2004 and April 2008, we prospectively evaluated all patients with known or suspected coronary artery disease (CAD) referred to the echocardiography laboratory for dobutamine stress tests (6061 examinations). Those with abnormal DSE underwent coronary angiogram with a systematic methylergometrine intracoronary injection in the case of absence of significant coronary stenosis or spontaneous occlusive coronary spasm. Patients who had spontaneous occlusive coronary spasm or positive methylergometrine test, but no significant stenoses, were ultimately included in this study. About 581 patients had abnormal DSE, among them only 20 (3.4%) fulfilled the inclusion criteria. There were 15 males and 5 females, and mean age was 64.35 years (range 52-85); 8 patients had a known history of CAD and all of them had at least two established cardiovascular risk factors. The culprit vessel was the left anterior descending artery in 10 cases (50%), right coronary artery in 8 cases (40%), and left circumflex in 2 cases (10%). There was a systematic correspondence between the culprit arteries and dobutamine-induced wall motion abnormality territories. No complications occurred during examination or during the provocation test. All the patients were discharged with a calcium channel blocker and were doing well after 13 months of mean follow-up. CONCLUSION: Coronary artery spasm can be induced at DSE, but is a rare finding; it could, though, be clinically relevant as it may partly explain some erroneously labelled 'false-positive' examinations. Methylergometrine provocation test is a safe and advisable approach in such situations.
Falah Aboukhoudir; Sofiene Rekik; Stephane Andrieu; Saida Cheggour; Michel Pansieri; Marc Metge; Pierre Barnay; Jean Paul Faugier; Sylvie Schouvey; Gonzalo Quaino; Clement Unal; Stéphanie Gonzalez; Jean Lou Hirsch
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Publication Detail:
Type:  Journal Article     Date:  2009-02-06
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  10     ISSN:  1532-2114     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-01     Completed Date:  2009-07-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  556-61     Citation Subset:  IM    
Cardiology Department, Avignon Hospital Center, Avignon, France.
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MeSH Terms
Adrenergic beta-Agonists / administration & dosage,  diagnostic use
Aged, 80 and over
Coronary Angiography
Coronary Artery Disease / complications,  radiography,  ultrasonography*
Coronary Stenosis / ultrasonography
Coronary Vasospasm / etiology*,  ultrasonography
Dobutamine / administration & dosage,  diagnostic use
Echocardiography, Stress / adverse effects*
False Positive Reactions
Methylergonovine / diagnostic use
Middle Aged
Oxytocics / diagnostic use
Prospective Studies
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Oxytocics; 113-42-8/Methylergonovine; 34368-04-2/Dobutamine

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