| Dobutamine versus dipyridamole for inducing reversible perfusion defects in chronic multivessel coronary artery stenosis. | |
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MedLine Citation:
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PMID: 12103272 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We hypothesized that, although the effects of dipyridamole and dobutamine on myocardial blood volume (MBV) and mean microbubble velocity (VEL) are different, the magnitude of perfusion deficit during both forms of stress is the same because both drugs unmask abnormal myocardial blood flow (MBF) reserve. BACKGROUND: Both dipyridamole and dobutamine are used clinically as pharmacologic stress agents to induce reversible perfusion defects in patients with chronic coronary artery disease (CAD), but the basis for doing so for dobutamine is not clear. METHODS: Eleven chronically instrumented closed-chest dogs with multivessel coronary stenosis were studied. Hemodynamics, radiolabeled microsphere-derived MBF, and myocardial contrast echocardiography (MCE)-derived myocardial perfusion were measured at rest, after dipyridamole infusion (0.56 mg x kg(-1)), and at peak dobutamine dose (either 30 or 40 microg x kg(-1) x min(-1)). Abnormal beds were defined as those demonstrating an MBF reserve <3 with dipyridamole. RESULTS: In the presence of either drug, MBV increased more in the normal bed than in the abnormal bed, but the increase was higher in both beds with dobutamine than with dipyridamole. The slope of the relationship between MBF reserve and MBV reserve was greater during dobutamine than dipyridamole (p < 0.05). The converse was true for VEL reserve (p < 0.05). Consequently, the relationship between the ratios of either variable, or the product of the two, between the abnormal bed and normal bed was similar for both drugs. CONCLUSIONS: Although the effects of dipyridamole and dobutamine on MBV and VEL are different, both are equally effective in detecting physiologically relevant coronary stenoses on MCE. Both can therefore be used interchangeably with myocardial perfusion imaging for the detection of CAD. |
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Authors:
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Jian-Ping Bin; Robert A Pelberg; Kevin Wei; D Elizabeth Le; N Craig Goodman; Sanjiv Kaul |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 40 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2002 Jul |
Date Detail:
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Created Date: 2002-07-09 Completed Date: 2002-07-26 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 167-74 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Imaging Center, the Cardiovascular Division, University of Virginia, Charlottesville, Virginia, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Flow Velocity / drug effects Cardiotonic Agents / diagnostic use*, pharmacology Coronary Circulation / drug effects, physiology* Coronary Stenosis / diagnosis, physiopathology* Dipyridamole / diagnostic use*, pharmacology Dobutamine / diagnostic use*, pharmacology Dogs Echocardiography Microspheres Vasodilator Agents / diagnostic use*, pharmacology |
| Grant Support | |
ID/Acronym/Agency:
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HL-07355/HL/NHLBI NIH HHS; K08-HL03909/HL/NHLBI NIH HHS; R01-HL66034/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Cardiotonic Agents; 0/Vasodilator Agents; 34368-04-2/Dobutamine; 58-32-2/Dipyridamole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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