Document Detail


Non-invasive detection of coronary artery disease by dobutamine-stress echocardiography in children after heart transplantation.
MedLine Citation:
PMID:  12909467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coronary vasculopathy is the main cause of cardiac graft failure. Because yearly coronary angiography is invasive in children, a non-invasive method for detecting graft vasculopathy is needed. The aim of this study was to test dobutamine-stress echocardiography in a pediatric population to determine its feasibility, safety and reliability in the detection of graft coronary artery disease. METHODS: Eighteen patients, aged 2 days to 16.8 years at transplantation (mean 8.4 years), underwent 44 dobutamine-stress echocardiography (DSE) exams, at a follow-up of 1.1 to 11.8 years (mean 5.1 years). Selective coronary angiography was performed for comparison. Echocardiographic recordings were obtained in 4 standard views of the left ventricle and measurements carried out within the frames of a 16-segment model. Segmental scores of contractility were obtained for each segment and a total segmental contractility index was calculated at each stage. RESULTS: All patients reached the maximum dose stage. Maximum heart rate was 57% to 90% of predicted maximum. Maximum systolic blood pressure reached 190 mmHg. Segmental scores were normal in 37 and abnormal in 7 cases. Echographic results were concordant with angiography in 82% and discordant in 18% of the cases (4 negative DSEs with minor angiographic lesions, 2 positive DSEs with normal angiography), but there was no significant angiographic lesion with normal DSE. CONCLUSIONS: DSE is a safe and highly feasible non-invasive technique in transplanted children. A normal DSE study successfully predicts the absence of significant coronary artery disease in the post-transplant population.
Authors:
Sylvie Di Filippo; Bertrand Semiond; Ricardo Roriz; Francois Sassolas; Marie José Raboisson; André Bozio
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  22     ISSN:  1053-2498     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-11     Completed Date:  2004-01-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  876-82     Citation Subset:  IM    
Affiliation:
Department of Paediatric Cardiology, Hôpital Cardilogique Louis Pradel, Lyon, France. sylvie.di.filippo@wanadoo.fr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiotonic Agents / administration & dosage,  adverse effects,  diagnostic use*
Child
Child, Preschool
Coronary Artery Disease / complications,  ultrasonography*
Dobutamine / administration & dosage,  adverse effects,  diagnostic use*
Echocardiography, Stress* / adverse effects
Feasibility Studies
Female
Graft Rejection / diagnosis*,  etiology
Heart Transplantation*
Humans
Infant
Infant, Newborn
Male
Reproducibility of Results
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine

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


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