Document Detail


Dobutamine stress echocardiography in hypertrophic cardiomyopathy.
MedLine Citation:
PMID:  14557696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Cardiology     Volume:  100     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:  2003  
Date Detail:
Created Date:  2003-10-14     Completed Date:  2004-04-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  93-100     Citation Subset:  IM    
Copyright Information:
Copyright 2003 S. Karger AG, Basel
Affiliation:
Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University of Naples, Via Pansini 5, IT-80131 Naples, Italy. losi@unina.it
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Agonists / 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:
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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