Document Detail


Safety of dobutamine stress echocardiography in patients with aortic stenosis.
MedLine Citation:
PMID:  12918844     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: Aortic valve disease is becoming one of the most important cardiac diseases in western society. Low-dose dobutamine stress echocardiography (DSE) is recommended in patients with low-gradient aortic stenosis (AS) and severe left ventricular (LV) dysfunction. DSE is also used in patients with AS and moderately reduced or normal LV function for diagnostic purposes. The study aim was to assess the safety of DSE in the setting of AS and various degrees of LV dysfunction. METHODS: A total of 75 patients with AS who underwent DSE at the authors' center between 1997 and 2001 was reviewed. Group A patients (n = 20) had severely reduced mean LV ejection fraction (LVEF) of 25 +/- 6% and underwent low-dose DSE; group B patients (n = 55) had moderate to normal LV function (LVEF 51 +/- 8%) and underwent high-dose DSE. The mean pressure gradient, valve area and side effects after DSE were evaluated. RESULTS: Serious cardiac arrhythmias occurred in 10 patients. In group A, four patients (20%) developed non-sustained ventricular tachycardia. In group B, two patients (4%) had non-sustained ventricular tachycardia (VT), four (7%) had paroxysmal supraventricular tachycardias, and two (4%) severe symptomatic hypotension. Among the 20 patients with evidence of ischemia on DSE, three developed adverse side effects (no difference compared with patients without ischemia; p = 0.922). Fourteen patients received atropine during DSE, and 1 of these developed non-sustained VT after atropine administration. CONCLUSION: Serious cardiac arrhythmias occur frequently during both low-dose and high-dose DSE in patients with AS. Adverse side effects do not relate to stress-induced ischemia or atropine addition.
Authors:
Manolis Bountioukos; Miklos D Kertai; Arend F L Schinkel; Eleni C Vourvouri; Vittoria Rizzello; Boudewijn J Krenning; Jeroen J Bax; Jos R T C Roelandt; Don Poldermans
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  12     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-08-15     Completed Date:  2003-12-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  441-6     Citation Subset:  IM    
Affiliation:
Thoraxcenter, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Agonists / administration & dosage,  adverse effects,  diagnostic use*
Aged
Aged, 80 and over
Aortic Valve / physiopathology,  ultrasonography
Aortic Valve Stenosis / diagnosis*,  epidemiology
Arrhythmias, Cardiac / chemically induced
Dobutamine / administration & dosage,  adverse effects,  diagnostic use*
Dose-Response Relationship, Drug
Echocardiography, Stress*
Equipment Safety
Female
Humans
Hypertrophy, Left Ventricular / diagnosis,  epidemiology
Incidence
Male
Middle Aged
Retrospective Studies
Severity of Illness Index
Stroke Volume / physiology
Ventricular Dysfunction, Left / diagnosis,  epidemiology
Ventricular Pressure / physiology
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 34368-04-2/Dobutamine
Comments/Corrections
Comment In:
J Heart Valve Dis. 2003 Jul;12(4):439-40   [PMID:  12918843 ]

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


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