Dobutamine versus dipyridamole for inducing reversible perfusion defects in chronic multivessel coronary artery stenosis

We hypothesized that, although the effects of dipyridamole and dobutamine on myocardial blood volume (MBV) and mean microbubble velocity (VEL) are different, the magnitude of perfusion deficit during both forms of stress is the same because both drugs unmask abnormal myocardial blood flow (MBF) rese...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2002-07, Vol.40 (1), p.167-174
Main Authors: Bin, Jian-Ping, Pelberg, Robert A, Wei, Kevin, Le, D.Elizabeth, Goodman, N.Craig, Kaul, Sanjiv
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Blood Flow Velocity - drug effects
Cardiology
Cardiotonic Agents - pharmacology
Cardiovascular system
Coronary Circulation - drug effects
Coronary Circulation - physiology
Coronary Stenosis - diagnosis
Coronary Stenosis - physiopathology
Coronary vessels
Defects
Dipyridamole - pharmacology
Dobutamine - pharmacology
Dogs
Echocardiography
Heart attacks
Hypotheses
Investigative techniques, diagnostic techniques (general aspects)
Laboratory animals
Medical sciences
Microspheres
Ostomy
Surgery
Ultrasonic investigative techniques
Vasodilator Agents - pharmacology
Veins & arteries
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Summary:We hypothesized that, although the effects of dipyridamole and dobutamine on myocardial blood volume (MBV) and mean microbubble velocity (VEL) are different, the magnitude of perfusion deficit during both forms of stress is the same because both drugs unmask abnormal myocardial blood flow (MBF) reserve. Both dipyridamole and dobutamine are used clinically as pharmacologic stress agents to induce reversible perfusion defects in patients with chronic coronary artery disease (CAD), but the basis for doing so for dobutamine is not clear. Eleven chronically instrumented closed-chest dogs with multivessel coronary stenosis were studied. Hemodynamics, radiolabeled microsphere-derived MBF, and myocardial contrast echocardiography (MCE)-derived myocardial perfusion were measured at rest, after dipyridamole infusion (0.56 mg·kg−1), and at peak dobutamine dose (either 30 or 40 μg·kg−1·min−1). Abnormal beds were defined as those demonstrating an MBF reserve
ISSN:0735-1097
1558-3597
DOI:10.1016/S0735-1097(02)01908-3