Document Detail


Dobutamine stress echocardiography as a predictor of cardiac events associated with aortic surgery.
MedLine Citation:
PMID:  1578539     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Two-dimensional echocardiography can detect regional wall motion abnormalities resulting from myocardial ischemia produced by dobutamine infusion. In 60 patients undergoing elective aortic surgery (27 with aneurysms, 33 with occlusive disease), we evaluated the ability of dobutamine stress echocardiography to predict perioperative cardiac events. Echo images were obtained at rest and during incremental dobutamine infusion to a peak dose of 50 micrograms/kg/min, unless another test end point was reached (angina, heart rate greater than or equal to 85% of age-predicted maximum, significant ST segment depression, or new stress-induced wall motion abnormalities). Dobutamine stress echocardiography results were stratified as follows: group I, no wall motion abnormalities; group II, resting wall motion abnormalities unchanged with stress; group III, stress-induced worsening of resting wall motion abnormalities; group IV, new-onset wall motion abnormalities with stress. Twelve cardiac events occurred within the first 30 postoperative days: three cardiac deaths (5%), six nonfatal myocardial infarctions (10%), two patients with unstable angina (3.3%), and one patient with asymptomatic elevation of creatine phosphokinase MB isoenzymes without electrocardiographic changes (1.7%). Eleven events occurred in the 38 patients with an abnormal dobutamine stress echocardiograph (groups II to IV); in contrast, only one of 22 patients with a normal dobutamine stress echocardiograph (group I) had a cardiac event. These event rates (29% vs 4.6%) differed significantly (p less than 0.025). Dobutamine stress echocardiography is a new, safe, rapid, relatively low cost, noninvasive, nonexercise cardiac stress test for risk stratification before major vascular surgery.
Authors:
S G Lalka; S G Sawada; M C Dalsing; D F Cikrit; A P Sawchuk; R L Kovacs; D S Segar; T Ryan; H Feigenbaum
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  15     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1992 May 
Date Detail:
Created Date:  1992-06-08     Completed Date:  1992-06-08     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  831-40; discussion 841-2     Citation Subset:  IM    
Affiliation:
Department of Surgery, Indiana University School of Medicine, Indianapolis.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aorta / surgery*
Coronary Disease / physiopathology,  ultrasonography*
Dobutamine / diagnostic use*
Echocardiography / methods*
Female
Humans
Intraoperative Complications / prevention & control
Logistic Models
Male
Middle Aged
Postoperative Complications / prevention & control
Predictive Value of Tests
Chemical
Reg. No./Substance:
34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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