Document Detail

Safety and feasibility of dobutamine and dipyridamole stress echocardiography in hypertensive patients.
MedLine Citation:
PMID:  12131540     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To establish whether safety and feasibility of dobutamine and dipyridamole stress echocardiography are affected by history of hypertension. METHODS: Data on 2200 consecutive pharmacologic stress echocardiography (959 dobutamine and 1241 dipyridamole) performed between October 1990 and February 2001 at a single cardiology centre, were analysed. RESULTS: There were two complications (1/480 tests) during dobutamine (one sustained ventricular tachycardia and one severe asthmatic attack following antidote administration) and two (1/620 tests) during dipyridamole (one non-Q wave myocardial infarction and one sustained ventricular tachycardia) stress. Complications or limiting side effects were observed in 83/959 patients (48/430 hypertensives and 35/529 normotensives) with dobutamine and in 34/1241 patients (17/571 hypertensives and 17/670 normotensives) with dipyridamole stress. Therefore, the overall feasibility was 88.8% in hypertensives and 93.4% in normotensives (P = 0.013) for dobutamine, and 97% in hypertensives and 97.5% in normotensives (P = 0.64) for dipyridamole. Dipyridamole was significantly more feasible than dobutamine in both hypertensive (P < 0.0001) and normotensive (P = 0.0006) subjects. Logistic regression analysis failed to identify clinical or echocardiographic predictors of adverse reactions with dipyridamole, while history of hypertension [odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.1-2.8, P = 0.0138] was the only independent predictor of cumulative adverse reactions with dobutamine stress. In addition, history of hypertension (OR = 3.2, 95% CI, 1.2-8.5, P = 0.0166), resting wall motion abnormalities (OR = 1.8, 95% CI, 1.1-3.1, P = 0.0282), and age over 70 years (OR = 4.8, 95% CI, 1.5-15.3, P = 0.0087) predicted hypertensive response, ventricular tachycardia, and atrial fibrillation, respectively. No covariate was associated with hypotensive response during dobutamine test. CONCLUSIONS: Dipyridamole has a slightly better safety profile and significantly higher feasibility than dobutamine stress both in hypertensives and in normotensives. In addition, the history of systemic hypertension is an independent predictor of cumulative adverse effects during dobutamine but not during dipyridamole stress.
Lauro Cortigiani; Luigi Zanetti; Riccardo Bigi; Alessandro Desideri; Cesare Fiorentini; Eugenio Nannini
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  20     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-19     Completed Date:  2003-01-23     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1423-9     Citation Subset:  IM    
Cardiovascular Unit, Campo di Marte Hospital, Lucca, Italy.
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MeSH Terms
Arrhythmias, Cardiac / chemically induced
Dipyridamole / therapeutic use*
Echocardiography, Stress*
Equipment Safety
Feasibility Studies
Hemodynamics / drug effects,  physiology
Hypertension / complications,  drug therapy*,  ultrasonography*
Middle Aged
Predictive Value of Tests
Treatment Outcome
Vasodilator Agents / therapeutic use*
Reg. No./Substance:
0/Vasodilator Agents; 58-32-2/Dipyridamole
Comment In:
J Hypertens. 2002 Jul;20(7):1287-9   [PMID:  12131522 ]

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