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Dobutamine Stress Echocardiography in Hypertrophic Cardiomyopathy
- Source :
- Università degli Studi di Napoli Federico II
- Publication Year :
- 2003
- Publisher :
- S. Karger AG, 2003.
-
Abstract
- Aims: Myocardial ischemia in the absence of coronary artery disease is common in patients with hypertrophic cardiomyopathy (HCM). Dobutamine stress echocardiography (DSE) induces left ventricular (LV) new wall motion abnormalities (NWMA) in some patients with HCM. We evaluated the effects of dobutamine on LV performance and hemodynamics in HCM. Methods and Results: Eighteen patients with non-obstructive HCM underwent DSE. Dobutamine was administered at dosages of 5, 10, 20, 30 and 40 µg/kg/min with increments at intervals of 3 min. Seven patients developed NWMA, whereas the other 11 did not. During DSE, heart rate increased significantly more in NWMA patients,whereas LV outflow tract gradient (OTG) increased significantly and similarly in both groups. At peak dobutamine dose, NWMA patients had a significant increase in LV end-systolic diameter and volume and a significant decrease in LV fractional shortening and ejection fraction. Posterior wall thickening increased significantly, whereas septal thickening did not increase throughout DSE in both groups. Conclusions: In a subgroup of patients with HCM, DSE induces NWMA, associated with a greater increase in heart rate, irrespective of LVOTG. NWMA induce a depression of global LV systolic performance. The septum shows no contractile reserve, regardless of NWMA. These phenomena may be the result of induction of ischemia and/or impaired LV systolic function due to fast heart rate.
- Subjects :
- Adult
Male
Tachycardia
medicine.medical_specialty
Heart disease
Dobutamine stress echocardiography
Heart Ventricles
Cardiomyopathy
Blood Pressure
Ventricular Function, Left
Angina Pectoris
Coronary artery disease
Heart Rate
Dobutamine
Internal medicine
Heart Septum
medicine
Stress Echocardiography
Humans
Pharmacology (medical)
cardiovascular diseases
Infusions, Intravenous
Observer Variation
Dose-Response Relationship, Drug
business.industry
Incidence
Hypertrophic cardiomyopathy
Stroke Volume
Adrenergic beta-Agonists
Cardiomyopathy, Hypertrophic
Middle Aged
medicine.disease
Tachycardia, Ventricular
Cardiology
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Echocardiography, Stress
medicine.drug
Subjects
Details
- ISSN :
- 14219751 and 00086312
- Volume :
- 100
- Database :
- OpenAIRE
- Journal :
- Cardiology
- Accession number :
- edsair.doi.dedup.....5fbb710b89fc82e67e29d2289a77b50e