Usefulness of low-dose dobutamine stress echocardiography for evaluating reversibility of brain death–induced myocardial dysfunction

• Published in: The American journal of cardiology 1999-09, Vol.84 (5), p.578-582
• Main Authors: Kono, Tatsuji, Nishina, Takuya, Morita, Hiroshi, Hirota, Yuzo, Kawamura, Keishiro, Fujiwara, Akira
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Brain Death - diagnostic imaging; Cardiology; Cardiology. Vascular system; Cardiotonic Agents; Dobutamine; Dose-Response Relationship, Drug; Echocardiography - drug effects; Electrocardiography; Exercise Test - drug effects; Female; Graft Survival - physiology; Heart; Heart Arrest - diagnostic imaging; Heart Failure - diagnostic imaging; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Heart Transplantation - physiology; Humans; Male; Medical sciences; Middle Aged; Mortality; Myocardial Contraction - drug effects; Troponin T - blood
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(99)00382-3

Many of the myocardial wall motion abnormalities in heart donors are reversible after transplantation, indicating that the presence of wall motion abnormalities should not automatically lead to the exclusion of donor hearts. The present study observes the natural course of brain death–induced myocardial dysfunction, and investigates whether low-dose dobutamine stress echocardiography could identify reversible myocardial dysfunction in brain-dead patients. We prospectively measured the serial changes of left ventricular fractional shortening (FS) using echocardiography and cardiac troponin T from admission to the time of cardiac standstill in 30 brain-dead patients. Patients were divided into 2 groups according to FS at the time of brain death; group I (FS ≥30%) and group II (FS