Transmitral pulsed-Doppler echocardiography is a more accurate technique compared with two-dimensional echocardiography using dobutamine, in patients with one vessel coronary artery disease

• Published in: European journal of heart failure 2003-01, Vol.5 (1), p.63-72
• Main Authors: Bajraktari, Gani, Qirko, Spiro, Fusco, Rossana, Milazzo, Angela, Xhaxho, Brunilda, Pezzano, Antonio
• Format: Article
• Language: English
• Subjects: Adrenergic beta-Agonists - administration & dosage; Aged; Coronary Artery Disease - diagnosis; Coronary Artery Disease - physiopathology; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; dobutamine; Dobutamine - administration & dosage; doppler echocardiography; Dose-Response Relationship, Drug; Echocardiography - methods; Echocardiography, Doppler, Pulsed - methods; Echocardiography, Stress; Female; Hemodynamics - drug effects; Humans; Male; Middle Aged; Mitral Valve - diagnostic imaging; myocardial ischaemia; Observer Variation; Prospective Studies; Sensitivity and Specificity; stress-echocardiography
• ISSN: 1388-9842; 1879-0844
• DOI: 10.1016/S1388-9842(02)00030-2

To examine the effects of dobutamine on pulsed‐Doppler left ventricular filling indices and its utility for evaluation of CAD we studied 14 patients with normal coronary arteries (Group 1) and 39 patients with significant CAD (>70% diameter stenosis). Patients with coronary artery disease (CAD) were divided into two groups: patients with one‐vessel coronary disease (Group 2); and those with multivessel CAD (Group 3). After stopping cardioactive treatment, patients underwent incremental dobutamine stress (5, 10, 20, 30 and 40 μg/kg/min) during pulsed‐Doppler interrogation of diastolic filling with simultaneous heart rate and blood pressure measurements. The following transmitral Doppler variables were measured at baseline and at peak‐dose of dobutamine: peak early (E) and peak atrial (A) velocity; E/A ratio; acceleration time (AT) and deceleration time (DT) of E wave; isovolumic relaxation time (IVRT); and time–velocity integral (TVI). Two‐dimensional echocardiography was performed to detect regional asinergy and analyzed using a 16 segment model. Results: Normals and CAD patients showed comparable changes in heart rate and blood pressure (P=NS between groups). Intergroup analysis of the changes of transmitral flow showed the significant changes for these indices (P