Stress Doppler echocardiography using dobutamine in coronary patients with and without ischaemia induction.

Abstract

To examine the effects of dobutamine on pulsed-Doppler left ventricular ejection dynamics and its utility for evaluation of coronary disease (CAD) we studied 10 patients with normal coronaries (Group 1) and 24 patients with significant CAD (greater than or equal to 70% diameter stenosis) using a graded stress infusion (5 to 20 micrograms.kg-1.min-1). Two-dimensional echocardiography was performed to detect regional asynergy and analysed using an 11-segment model. Patients with CAD were divided into those with (Group 3, n = 14) and without (Group 2, n = 10) inducible ischaemia; six patients had reversible involvement of greater than or equal to three segments (subset 3A). Groups were well matched for baseline left ventricular function and all studies were carried out while the patients were not taking cardioactive therapy. Hyperkinetic wall motion was typical and exaggerated hyperkinesis of normal segments was commonly seen in those with baseline (n = 9) or reversible asynergy (n = 14). Normals and CAD patients showed comparable changes in heart rate and blood pressure (P = NS between groups).(ABSTRACT TRUNCATED AT 250 WORDS)