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EFFECTS OF DOBUTAMINE ON TISSUE DOPPLER VELOCITIES IN PATIENTS WITH NORMAL WALL MOTION AT REST
Author(s) -
Pariona M.,
Mendoza A.,
Rivara. G.
Publication year - 2004
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.0742-2822.2004.t01-12-20040211.x
Subject(s) - cardiology , medicine , dobutamine , diastole , rest (music) , doppler effect , mitral annulus , ischemia , doppler imaging , hemodynamics , blood pressure , physics , astronomy
Background: Dobutamine stress echocardiography (DSE) is a well‐recognized test to diagnose myocardial ischemia; however, it depends on operator subjective evaluation: it has been reported that pulsed Tissue Doppler (PTD) velocities at the mitral annulus provide information of both left ventricular systolic and diastolic function; we therefore evaluated the effect of dobutamine (DOB) on PTD in search of markers of ischemia. Methods: We prospectively studied 139 patients with normal wall motion (male: 54%; age: 65 ± 10 years) referred to a dobutamine stress echocardiography (DSE). Measurements were done at the lateral (L) and septal (S) annulus and included early diastolic filling velocity (Em), late diastolic filling velocity (Am), systolic velocity (Sm), and the ratio of early‐to‐late diastolic filling velocities (Em/Am). Results: One hundred and six (76%) patients had a normal response to DOB and 33 (23%) had an ischemic response. The PTD differences between the patients with either normal or ischemic response,respectively,were: rest L Em 11.6 ± 3.1 vs. 12.± 3.8 (p = 0.1207), peak L Em 14 ± 3.9 vs. 12.7 ± 4 (p < 0.0206); rest S Em 9.6 ± 2.1 vs. 9.1 ± 2.6 (p < 0.4335), peak S Em 12 ± 4.6 vs. 10.7 ± 2.3 (p = 0.0473). Both S and L Sm were significantly different at rest and at peak. A trend to a more negative E/A ratio was found in both groups. PTD velocities (mean ± SD) are shown in table. TABLE
Pulse Tissue Doppler Velocities at Rest and at Peak StressNormal Ischemic P ValueRest lateral Em 11.6 ± 3.1 12 ± 3.8 0.1207 Peak lateral Em 14 ± 3.9 12.7 ± 4 0.006 Rest septal Em 9.6 ± 2.1 9.1 ± 2.6 0.4335 Peak septal Em 12 ± 4.6 10.7 ± 2.3 0.0473 Rest lateral Sm 10.2 ± 2.4 8.73 ± 3.2 0.0139 Peak lateral Sm 21.9 ± 6.1 16.7 ± 5 0.005 Rest septal Sm 10.6 ± 2.6 8.8 ± 4.7 0.0081 Peak septal Sm 21.5 ± 5 16.7 ± 6.2 0.0183Conclusion: Pulse tissue Doppler Em could be a useful marker of ischemic response during dobutamine stress echocardiography.