Document Detail

Relative sensitivity of echocardiography and systolic time intervals for assessing acute positive inotropic interventions in normal human subjects.
MedLine Citation:
PMID:  7136998     Owner:  NLM     Status:  MEDLINE    
The relative ability of M-mode echocardiography (EC) and systolic time intervals (STIs) to quantify acute positive inotropic interventions (PI) concurrently validated by hemodynamic measurements is unknown. Thus we studied the response of eight patients with normal coronary arteriography and LV function to successive incremental infusions of dobutamine (D-1, D-2) during cardiac catheterization. During D-1 with heart rate, arterial pressure and LV end-diastolic pressure unchanged, dP/dt max increased 65% (p less than or equal to 0.001), QS2 decreased 12% (p less than or equal to 0.01), PEP decreased 24% (p less than or equal to 0.01), LVET and PEP/LVET were not significantly changed, while EC %delta D and mean Vcf increased by 22% and 33% (both p less than or equal to 0.01). During D-2 with heart rate increased (increases 33%, p less than or equal to 0.001), EC Vcf (increases 66%, p less than or equal to 0.01) and PEP (decreases 33%, p less than or equal to 0.001) exhibited the greatest changes of the noninvasive parameters. The observed decreases in QS2 and LVET but not PEP were considerably attenuated after normalization for heart rate. Our data suggest: (1) echo and STIs are complementary in assessing PI; (2) PEP is more sensitive than QS2 in quantitating PI, particularly when large increases in contractile enhancement have occurred; and (3) both noninvasive techniques are less sensitive than dP/dt in detecting positive inotropic action.
R A Walsh; M H Crawford; R A O'Rourke
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American heart journal     Volume:  104     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1982 Nov 
Date Detail:
Created Date:  1982-12-16     Completed Date:  1982-12-16     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1061-70     Citation Subset:  AIM; IM    
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MeSH Terms
Blood Pressure / drug effects
Cardiac Output / drug effects
Catecholamines / pharmacology*
Dobutamine / pharmacology*
Heart Rate / drug effects
Middle Aged
Myocardial Contraction / drug effects*
Stimulation, Chemical
Stroke Volume / drug effects
Systole / drug effects
Grant Support
Reg. No./Substance:
0/Catecholamines; 34368-04-2/Dobutamine

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

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