| Dobutamine stress echocardiography in hypertrophic cardiomyopathy. | |
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MedLine Citation:
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PMID: 14557696 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Myocardial ischemia in the absence of coronary artery disease is common in patients with hypertrophic cardiomyopathy (HCM). Dobutamine stress echocardiography (DSE) induces left ventricular (LV) new wall motion abnormalities (NWMA) in some patients with HCM. We evaluated the effects of dobutamine on LV performance and hemodynamics in HCM. METHODS AND RESULTS: Eighteen patients with non-obstructive HCM underwent DSE. Dobutamine was administered at dosages of 5, 10, 20, 30 and 40 microg/kg/min with increments at intervals of 3 min. Seven patients developed NWMA, whereas the other 11 did not. During DSE, heart rate increased significantly more in NWMA patients,whereas LV outflow tract gradient (OTG) increased significantly and similarly in both groups. At peak dobutamine dose, NWMA patients had a significant increase in LV end-systolic diameter and volume and a significant decrease in LV fractional shortening and ejection fraction. Posterior wall thickening increased significantly, whereas septal thickening did not increase throughout DSE in both groups. CONCLUSIONS: In a subgroup of patients with HCM, DSE induces NWMA, associated with a greater increase in heart rate, irrespective of LVOTG. NWMA induce a depression of global LV systolic performance. The septum shows no contractile reserve, regardless of NWMA. These phenomena may be the result of induction of ischemia and/or impaired LV systolic function due to fast heart rate. |
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Authors:
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Maria Angela Losi; Sandro Betocchi; Mariano Aversa; Raffaella Lombardi; Marianna Miranda; Alessandra Cacace; Quirino Ciampi; Carlo Gabriele Tocchetti; Adriana Guida; Massimo Chiariello |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article |
Journal Detail:
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Title: Cardiology Volume: 100 ISSN: 0008-6312 ISO Abbreviation: Cardiology Publication Date: 2003 |
Date Detail:
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Created Date: 2003-10-14 Completed Date: 2004-04-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1266406 Medline TA: Cardiology Country: Switzerland |
Other Details:
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Languages: eng Pagination: 93-100 Citation Subset: IM |
Copyright Information:
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Copyright 2003 S. Karger AG, Basel |
Affiliation:
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Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University of Naples, Via Pansini 5, IT-80131 Naples, Italy. losi@unina.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Agonists
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administration & dosage,
adverse effects,
diagnostic use Adult Angina Pectoris / chemically induced Blood Pressure / drug effects Cardiomyopathy, Hypertrophic / diagnosis*, physiopathology Dobutamine / administration & dosage, adverse effects, diagnostic use Dose-Response Relationship, Drug Echocardiography, Stress* Female Heart Rate / drug effects Heart Septum / drug effects, physiopathology Heart Ventricles / drug effects, physiopathology Humans Incidence Infusions, Intravenous Male Middle Aged Observer Variation Stroke Volume / drug effects Tachycardia, Ventricular / chemically induced Ventricular Function, Left / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Agonists; 34368-04-2/Dobutamine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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