Document Detail

Regional wall motion changes with dobutamine as a pharmacological stress test during cardiac catheterization in patients with significant coronary artery disease.
MedLine Citation:
PMID:  9057679     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Preliminary study to test the feasibility of pharmacological stress testing during cardiac catheterization, thus combining anatomical and functional information. PATIENTS AND METHODS: 21 consecutive patients with known or suspected coronary artery disease, referred for diagnostic catheterization. Biplane ventriculography was performed before and during dobutamine infusion. The patients were subdivided into 3 groups: Group I (n = 11, 52%) with at least one territory supplied by a significantly stenosed coronary artery and showing normal resting regional wall motion. Group II (n = 6, 29%) patients in whom the affected vessel(s) supplied exclusively a territory with regional wall motion abnormalities at rest. Group III (n = 4, 19%) had no significant coronary artery disease and served as control. RESULTS: In group I, 9/11 (82%) patients and in group II, 3/6 (50%) patients showed either ischemia or viability reactions or both after dobutamine stress. Overall, substantial functional information was gathered in 12/17 patients (71%). Control patients showed no worsening of regional wall motion under dobutamine. Neither global left ventricular ejection fraction nor left ventricular end diastolic pressure were as accurate in detecting ischemia as regional wall motion analysis. In patients who had only ischemia and no viability reaction as judged by regional wall motion analysis, ejection fraction fell significantly in 4/6 (67%) patients; end diastolic pressure on the other hand rose significantly in 3/6 (50%). CONCLUSIONS: Dobutamine stress testing performed during cardiac catheterization is convenient, feasible and safe and yields clinically useful information in a high percentage (71%) of patients with significant coronary artery disease. Further experience is needed to evaluate the sensitivity, specificity and predictive value of this new approach.
P Wagdi; M Fluri; G Rouvinez; B Meier
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Japanese heart journal     Volume:  37     ISSN:  0021-4868     ISO Abbreviation:  Jpn Heart J     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1997-03-19     Completed Date:  1997-03-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401175     Medline TA:  Jpn Heart J     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  847-53     Citation Subset:  IM    
Division of Cardiology, University Hospital, Bern, Switzerland.
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MeSH Terms
Coronary Disease / diagnosis*,  physiopathology
Dobutamine / diagnostic use*,  pharmacology
Exercise Test
Feasibility Studies
Heart Catheterization*
Myocardial Contraction / drug effects*
Predictive Value of Tests
Sensitivity and Specificity
Stroke Volume / drug effects
Ventricular Function, Left / drug effects
Reg. No./Substance:

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