Dobutamine Stress Echocardiography
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Contents |
Introduction
- Dobutamine stress used in connection with echocardiography in the evaluation of heart motion in patients with chest pain. In patients with significant coronary artery disease ( CAD), dobutamine induces segmental wall motion abnormalities in the region of distribution of the diseased vessels. Left ventricular dilatation occurs when large areas are involved. Myocardial viability may be determined by identifying increased wall motion in myocardial segments akinetic at baseline.
- Dobutamine may be supplemented with atropine to increase heart rate. In contrast to exercise, maximal heart rate is not suppressed by beta-blockers. Hypotension associated with dobutamine infusion may limit maximum dobutamine dosage, but has no diagnostic relevance.
- ST segment & T-wave changes with dobutamine infusion may indicate ischemia, but do NOT add to test accuracy (except for risk stratification).
- Dobutamine stress echocardiography is also useful for stratifying risk in patients with known or suspected CAD [2]. Dobutamine- induced left ventricular dysfunction & or evidence of ischemia are independent predictors of cardiac mortality.
- prognostic value similar to myocardial perfusion scintigraphy [3]
Complications
More General Terms
Additional Terms
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- Journal Watch 21(8):64, 2001 Marwick et al J Am Coll Cardiol 37:754, 2001
- Journal Watch 24(16):126, 2004 a) Schinkel AF, Bax JJ, Elhendy A, van Domburg RT, Valkema R, Vourvouri E, Bountioukos M, Rizzello V, Biagini E, Agricola E, Krenning EP, Simoons ML, Poldermans D. Long-term prognostic value of dobutamine stress echocardiography compared with myocardial perfusion scanning in patients unable to perform exercise tests. Am J Med. 2004 Jul 1;117(1):1-9. PMID: [1]
- Marwick TH. Does the extent of malperfusion or ischemia on stress testing predict future cardiac events? Am J Med. 2004 Jul 1;117(1):58-9. No abstract available. PMID: [2]
