Dobutamine stress echocardiography

Dobutamine is a synthetic catecholamine with predominant β-stimulation. Its half-life is approximately 2 min. The positive chronotropic and inotropic effects of dobutamine induce myocardial ischaemia if significant coronary artery obstruction is present. Regional ischaemia produces regional wall mot...

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Bibliographic Details
Published in:European heart journal 1997-06, Vol.18 (suppl-D), p.9-15
Main Authors: Krahwinkel, W., Ketteler, T., Gödke, J., Wolfertz, J., Ulbricht, L. J., Krakau, I., Gülker, H.
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - adverse effects
coronary artery disease
Coronary Disease - diagnosis
Diagnosis, Differential
Dobutamine - adverse effects
Dobutamine stress echocardiography
Echocardiography - adverse effects
Echocardiography - methods
Electrocardiography
Exercise Test - adverse effects
Exercise Test - methods
Hemodynamics - drug effects
Hemodynamics - physiology
Humans
myocardial viability
Sensitivity and Specificity
stress-induced myocardial ischaemia
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Summary:Dobutamine is a synthetic catecholamine with predominant β-stimulation. Its half-life is approximately 2 min. The positive chronotropic and inotropic effects of dobutamine induce myocardial ischaemia if significant coronary artery obstruction is present. Regional ischaemia produces regional wall motion abnormalities which can be detected by echocardiography. Most dobutamine stress protocols start at an infusion rate of 5 μg. kg−1. min−1 and increase to a peak dose of 40 or 50 μg. kg−1. min−1; to further increase heart rate, a bolus injection of 0·25–1·0 mg atropine is added. Test endpoints are the detection of new wall motion abnormalities, the occurrence of severe complications or achievement of the target heart rate. Viable myocardial regions have a positive inotropic reserve, which can be stimulated by dobutamine and detected by echocardiography. Indications for the use of dobutamine stress echo-cardiography are to prove stress-inducible myocardial ischaemia and to detect myocardial viability. The test should only be performed for the detection of stress-induced myocardial ischaemia if patients are unable to undergo exercise echocardiography, or if patients fail to reach their required test level in exercise echocardiography.
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/18.suppl_D.9