In this study we showed that the use of second harmonic imaging during dobutamine stress echocardiography improved the accuracy of the detection of viable myocardium in patients with severe left ventricular dysfunction compared with fundamental imaging, DISA-SPECT being used as a reference method. Compared with fundamental imaging, the agreement between dobutamine stress echocardiography and DISA-SPECT on viability assessment increased significantly from 78% (κ = 0.56) to 89% (κ = 0.77) when second harmonic imaging was used (p = 0.001).. Although the use of combined low/high dose dobutamine echocardiography has improved the accuracy of dobutamine stress echocardiography for detecting viability,21 22 there remains some discordance between dobutamine echocardiography and nuclear imaging.23-25 Previous studies have shown that 201thallium classified a significantly higher percentage of segments as viable compared with dobutamine stress echocardiography.7 24 A similar discrepancy was observed ...
TY - JOUR. T1 - Inotropic contractile reserve can risk-stratify patients with HIV cardiomyopathy. T2 - A dobutamine stress echocardiography study. AU - Wever-Pinzon, Omar. AU - Bangalore, Sripal. AU - Romero, Jorge. AU - Silva Enciso, Jorge. AU - Chaudhry, Farooq A.. PY - 2011/12/1. Y1 - 2011/12/1. N2 - The purpose of this study was to assess whether inotropic contractile reserve (ICR) during dobutamine stress echocardiography (DSE) could risk-stratify patients with human immunodeficiency virus (HIV) cardiomyopathy and predict improvement of left ventricular ejection fraction (LVEF). HIV cardiomyopathy is an important cause of heart failure and death. ICR is associated with better survival and improvement of LVEF in patients with ischemic and nonischemic cardiomyopathies. However, the prognostic value of ICR in patients with HIV cardiomyopathy is unknown. Patients with HIV cardiomyopathy and a LVEF ,45% who were referred for DSE were enrolled. ICR was evaluated by the delta wall motion score ...
Is there a long-term predictive value of intraoperative low-dose dobutamine echocardiography in patients who have coronary artery bypass graft surgery with cardiopulmonary bypass?
Objective: To evaluate the relative merits of viability and ischaemia for prognosis after revascularisation.. Methods: Low-high dose dobutamine stress echocardiography (DSE) was performed before revascularisation in 128 consecutive patients with ischaemic cardiomyopathy (mean (SD) left ventricular ejection fraction (LVEF) 31 (8)%). Viability (defined as contractile reserve (CR)) and ischaemia were assessed during low and high dose dobutamine infusion, respectively. Cardiac death was evaluated during a five year follow up. Clinical, angiographic, and echocardiographic data were analysed to identify predictors of events.. Results: Univariable predictors of cardiac death were the presence of multivessel disease (hazard ratio (HR) 0.21, p , 0.001), baseline LVEF (HR 0.90, p , 0.0001), wall motion score index (WMSI) at rest (HR 4.02, p = 0.0006), low dose DSE (HR 7.01, p , 0.0001), peak dose DSE (HR 4.62, p , 0.0001), the extent of scar (HR 1.39, p , 0.0001), and the presence of CR in ⩾ 25% of ...
The major new finding of this study is the evidence that systemic BP changes are important determinants of peripheral sympathetic nerve control and HR response during dobutamine infusion. In young controls, dobutamine infusion markedly increased BP, which activated the arterial baroreceptors leading to subsequent inhibition of MSNA, as well as to limitation in the increase in HR. In contrast, the BP response to dobutamine was much less marked in the matched controls and, in the absence of arterial baroreceptor activation, dobutamine infusion did not change MSNA and did not limit the increase in HR. These findings are important as they may account for variations in the HR responses among subjects during dobutamine stress testing.. The response in the patients with severe CHF was similar to that observed in the matched controls, with no elevation in MBP and no changes in MSNA. The lack of increase in HR could be explained by the marked beta-adrenergic downregulation in end-stage HF (14). Resting ...
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Protocols for DSE vary from institution to institution, particularly with regard to dobutamine dose (range 20 to 40 μg/kg per min), atropine addition (range 0 to 2 mg) and stage duration (range 2 to 8 min) [5-32, 37]. Usually, centers that use lower peak doses of dobutamine use longer stage durations and stop beta-adrenergic blocking agent treatment more often before the test. To date, the most widely used protocol uses dobutamine up to 40 μg/kg per min, with the addition of atropine up to 1 mg [14].. According to this protocol, a rest electrocardiogram (ECG) and two-dimensional echocardiogram are acquired, intravenous access is secured, and dobutamine is then administered intravenously by an infusion pump, starting at 5 or 10 μg/kg per min for 3 min, increasing by 10 μg/kg per min every 3 min up to a maximum of 40 μg/kg per min. In patients not achieving 85% of their theoretic maximal heart rate (220 beats/min minus age for men, beats/min 200 minus age for women) and without symptoms or ...
Introduction: Patients with severe aortic stenosis and low mean transvalvular gradient have poor outcomes with an estimated 30 day post-surgical Aortic Valve Replacement (AVR) mortality of 21%. Low Dose Dobutamine Stress Echocardiography (LD-DSE) is performed in these patients for further risk stratification by determining the presence of myocardial reserve - defined as an at least 20% increase in stroke volume with Dobutamine infusion. These patients have lower perioperative mortality. However, it is unclear if LD-DSE can predict outcomes in high surgical risk patients undergoing Transcatheter Aortic Valve Implantation (TAVI).. Methods: We retrospectively identified patients from the PARTNER trial who underwent TAVI and had a LD-DSE as part of the inclusion criteria when the resting mean aortic gradient is ,40 mmHg. Outcomes identified in these patients after TAVI include re-hospitalizations for cardiac causes and mortality at 30 days and at one year.. Results: Twenty-four patients who ...
Current techniques for diagnosing perioperative myocardial infarction were studied in 58 patients who underwent coronary bypass surgery. All patients had preoperative and postoperative ECGs and technetium-99m stannous pyrophosphate myocardial scintigrams; serum CK-MB was measured immediately after surgery and daily for 3 days. Postoperative bypass graft visualization and left ventriculography were performed before hospital discharge in every patient. Nine patients (16%) had new Q waves postoperatively. Five of these nine patients had positive pyrophosphate scintigrams, postive CK-MB and new wall motion abnormalities, and the remaining four had negative CK-MB, negative phyrophosphate scintigrams and no new wall motion abnormalities. Seven patients (12%) had newly positive postoperative pyrophosphate scintigrams, positive CK-MB and new wall motion abnormalities on postoperative ventriculography, but only four had new Q waves postoperatively. Eight patients (14%) had new wall motion abnormalities; ...
The aim of this study was to investigate the temporal variability and interobserver agreement of dobutamine digital stress echocardiography. We performed two dobutamine stress echocardiographic studies (dobutamine up to 40 micrograms/kg/min and atrop
A dobutamine stress echocardiogram is a diagnostic procedure that may be used when a doctor wants to assess the heart muscle under stress. If exercise on a treadmill is not an option (too much stress on the heart) due to a persons medical condition, a doctor may use an intravenous medication called dobutamine. Dobutamine causes the heart to beat faster and will mimic the effects of exercise on the heart.. An echocardiogram is a noninvasive (the skin is not pierced) procedure used to assess the hearts function and structures. During the procedure, a transducer (like a microphone) sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed on the chest at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the heart tissues, where the waves bounce or "echo" off of the heart structures. The transducer picks up the reflected waves and sends them to a computer. The computer displays the echoes as images of ...
A dobutamine stress echocardiogram is a diagnostic test to assess the heart muscle under stress. If exercise on a treadmill is not an option (too much stress on the heart) due to a persons medical condition, a doctor may use an intravenous medicine called dobutamine. Dobutamine causes the heart to beat faster and will mimic the effects of exercise on the heart.
TY - JOUR. T1 - Real-Time Three-Dimensional Dobutamine Stress Echocardiography. T2 - A Valuable Adjunct or a Superior Alternative to Two-Dimensional Stress Echocardiography?. AU - Ahmad, Masood. PY - 2009/5. Y1 - 2009/5. UR - http://www.scopus.com/inward/record.url?scp=65549091149&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=65549091149&partnerID=8YFLogxK. U2 - 10.1016/j.echo.2009.03.024. DO - 10.1016/j.echo.2009.03.024. M3 - Article. C2 - 19450740. AN - SCOPUS:65549091149. VL - 22. SP - 443. EP - 444. JO - Journal of the American Society of Echocardiography. JF - Journal of the American Society of Echocardiography. SN - 0894-7317. IS - 5. ER - ...
Dobutamine hydrochloride is a direct-acting inotropic agent whose primary activity results from stimulation of the β receptors of the heart while producing comparatively mild chronotropic, hypertensive, arrhythmogenic, and vasodilative effects. It does not cause the release of endogenous norepinephrine, as does dopamine. In animal studies, dobutamine hydrochloride produces less increase in heart rate and less decrease in peripheral vascular resistance for a given inotropic effect than does isoproterenol.. In patients with depressed cardiac function, both dobutamine hydrochloride and isoproterenol increase the cardiac output to a similar degree. In the case of dobutamine hydrochloride, this increase is usually not accompanied by marked increases in heart rate (although tachycardia is occasionally observed), and the cardiac stroke volume is usually increased. In contrast, isoproterenol increases the cardiac index primarily by increasing the heart rate while stroke volume changes little or ...
The pharmacological effects of dobutamine (see Table 10-1 for structure) result from direct interactions with a and b receptors and are complex. The preparation of dobutamine used clinically is a racemate. The (-) isomer of dobutamine is a potent a1 agonist and pressor; (+) dobutamine is a potent a1 antagonist that can block the effects of (-) dobutamine. Both isomers are full agonists at b receptors, but the (+) isomer is more potent than the (-) isomer by -tenfold.. Was this article helpful?. ...
Dobutamine Injection, USP is a clear, practically colorless, sterile, nonpyrogenic solution of dobutamine hydrochloride for intravenous use only. Each milliliter contains 12.5 mg (41.5 µmol) dobutamine, as the hydrochloride and sodium metabisulfite, 0.2 mg added as antioxidant. May contain hydrochloric acid and/or sodium hydroxide for pH adjustment. pH is 3.3 (2.5 to 5.5).. Dobutamine Hydrochloride, USP is chemically designated (±)-4-[2-[[3-(ρ-hydroxyphenyl)-1-methylpropyl] amino]ethyl]-pyrocatechol hydrochloride.. It is a synthetic catecholamine.. ...
Thesis, English, Role of Mitral Inflow Patterns as a Predictor of Absence of Myocardial Viability Detected by Dobutamine Stress Echocardiography in Patients With Ischemic Cardiomyopathy for Fathy Mohamed Ismail Heba
Dobutamine stress echocardiograms are used to diagnose certain heart conditions. This type of echocardiogram was created for patients who are physically unable to exercise on a treadmill or stationary cycle. This type of echocardiogram utilizes a special medication called dobutamine. Essentially, this medication mimics regular echocardiograms, stimulating your heart so it appears that you are exercising. The dobutamine allows cardiologists to:. ...
Dobutamine stress echocardiography (DSE) is an accurate noninvasive test used for the diagnosis and evaluation of patients with known or suspected coronary artery disease (CAD). The aim of this study was to determine the rate of positive findings in
[Coronary Spasm after Administration of Propranolol during Dobutamine Stress Echocardiography]. - Lucía Alvarez, José Zamorano, Luis Mataix, Carlos Almeria, Raúl Moreno, José Luis Rodrigo
Definition of dobutamine in the Definitions.net dictionary. Meaning of dobutamine. What does dobutamine mean? Information and translations of dobutamine in the most comprehensive dictionary definitions resource on the web.
TY - JOUR. T1 - A clinical and echocardiographic score for assigning risk of major events after dobutamine echocardiograms. AU - Marwick, Thomas H.. AU - Case, Colin. AU - Poldermans, Don. AU - Boersma, Eric. AU - Bax, Jeroen. AU - Sawada, Stephen. AU - Thomas, James D.. PY - 2004/6/2. Y1 - 2004/6/2. N2 - Objectives We sought to develop and validate a risk score combining both clinical and dobutamine echocardiographic (DbE) features in 4,890 patients who underwent DbE at three expert laboratories and were followed for death or myocardial infarction for up to five years. Background In contrast to exercise scores, no score exists to combine clinical, stress, and echocardiographic findings with DbE. Methods Dobutamine echocardiography was performed for evaluation of known or suspected coronary artery disease in 3,156 patients at two sites in the U.S. After exclusion of patients with incomplete follow-up, 1,456 DbEs were randomly selected to develop a multivariate model for prediction of events. ...
Dobutamine stress echocardiogram - Cardiac ultrasound scan to assess the response of your heart to stress. Learn about costs, procedure and recovery.
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A stress echo is a test that takes pictures of the heart with the use of a probe placed outside your chest wall while your heart is working hard. To "stress" the heart, youll be given an intravenous medication (Dobutamine) that will make your heart beat harder and faster just like it would during exercise. ​​. The pictures taken before, during and after your heart is "stressed" are displayed on the ultrasound monitor and are recorded on a disk for review and comparison. A dobutamine stress echo is performed by a sonographer and interpreted by a cardiologist ...
Propranolol is a competitive antagonist which specifically competes with beta-adrenergic. by sufficient doses of such agonists as isoproterenol or dobutamine.Hemodynamic Effects of Atropine, Dobutamine, Nitroprusside, Phenylephrine, and Propranolol in Conscious Horses.. Antimigraine, Cardiovascular Agent (About this - PubMed Health).Medications that have been reported to negatively interact with propranolol include clonidine, digitalis, dobutamine, haloperidol, isoproterenol, blood ...
Preventing perioperative tissue oxygen debt contributes to a better postoperative recovery. Whether the beneficial effects of fluids and inotropes during optimization of the oxygen delivery index (DO2I) in high-risk patients submitted to major surgeries are due to fluids, to inotropes, or to the combination of the two is not known. We aimed to investigate the effect of DO2I optimization with fluids or with fluids and dobutamine on the 60-day hospital mortality and incidence of complications. A randomized and controlled trial was performed in 50 high-risk patients (elderly with coexistent pathologies) undergoing major elective surgery. Therapy consisted of pulmonary artery catheter-guided hemodynamic optimization during the operation and 24 hours postoperatively using either fluids alone (n = 25) or fluids and dobutamine (n = 25), aiming to achieve supranormal values (DO2I | 600 ml/minute/m2). The cardiovascular depression was an important component in the perioperative period in this group of patients.
TY - JOUR. T1 - A method of detecting and quantifying severity of myocardial perfusion defects with intravenous ultrasound contrast and breath holding during stress echocardiography. AU - Porter, Thomas Richard. AU - OLeary, Edward Lewis. AU - Silver, Mary. AU - Oehlke, Heidi. AU - Xie, Feng. PY - 2003/7/1. Y1 - 2003/7/1. N2 - Although breath holding is commonly used to improve and maintain image quality during stress echocardiography, its effects on the qualitative and quantitative analysis of myocardial contrast enhancement (MCE) following intravenously injected microbubbles is unknown. The purpose of this study was to determine how breath holding affects MCE following either an intravenous bolus or continuous infusion of perfluorocarbon containing microbubbles. In 48 patients, intravenous Optison was given at peak dobutamine stress to assess myocardial perfusion. The degree of myocardial opacification was assessed immediately following a breath hold in inspiration (BHini), at the end of a ...
1. We have studied whether the progressive rise in peripheral resistance observed in response to chronic intracoronary administration of dobutamine in conscious dogs could have resulted from extracardiac or non-β-adrenergic cardiac effects of the drug.. 2. Six conscious dogs received dobutamine, 1.56 × 10−8 mol min−1 kg−1, intravenously for a 7 day period and seven conscious dogs were given dobutamine, 1.51 × 10−8 mol min−1 kg−1, into the left coronary artery under oral propranolol treatment for the same period while arterial pressure, cardiac output (electromagnetic flowmeter) and heart rate were measured.. 3. Intravenous dobutamine produced no increase in arterial pressure, but a decrease in peripheral resistance and an increase in cardiac output which persisted until the end of the infusion.. 4. With propranolol treatment intracoronary dobutamine induced no significant haemodynamic changes but a short-lasting increase in mean arterial pressure and peripheral resistance.. 5. It ...
The preparation for the DSE procedure is similar to that of the basic echo described above. In addition, an IV line will be started in your hand or arm, and a blood pressure cuff will be placed on your arm. You may be asked not to take certain medications before the procedure that could interfere with the test results. A baseline assessment of your heart rate and blood pressure will be done.. The echocardiography technician will apply warmed gel to your chest. Then he or she will position the transducer on your chest and use a small amount of pressure to obtain the desired image. The dobutamine infusion will begin at a rate determined by your weight. The rate of the infusion will be increased every three minutes until you have reached your target heart rate (determined by the doctor based on your age and physical condition) or until the maximum dose of dobutamine has been reached. After the dobutamine is started and after each increase in the dobutamine rate, your blood pressure will be checked, ...
OBJECTIVE-This study sought to determine whether stress echocardiography using exercise (when feasible) or dobutamine echo could be used to predict mortality in patients with diabetes.. RESEARCH DESIGN AND METHODS-Stress echo was performed in 937 patients with diabetes (aged 59 ± 13 years, 529 men) for symptom evaluation (42%) and follow-up of known coronary artery disease (CAD) (58%). Stress echocardiography using exercise was performed in 333 patients able to exercise maximally, and dobutamine echo using a standard dobutamine stress was used in 604 patients. Patients were followed for ≤9 years (mean 3.9 ± 2.3) for all-cause mortality.. RESULTS-Normal studies were obtained in 567 (60%) patients; 29% had resting left ventricular (LV) dysfunction, and 25% had ischemia. Abnormalities were confined to one territory in 183 (20%) patients and to multiple territories in 187 (20%) patients. Death (in 275 [29%] patients) was predicted by referral for pharmacologic stress (hazard ratio [HR] 3.94, P , ...
Drug Information on dobutamine includes side effects, uses, drug interactions, dosage, drug pictures, overdose symptoms, and what to avoid.
in Journal of Cardiovascular Pharmacology (2005), 45(2), 144-152. This study investigated the effects of dobutamine on left ventriculoarterial (VA) coupling and mechanical efficiency in acutely ischemic pigs. Experiments were performed in 12 pigs in which vascular ... [more ▼]. This study investigated the effects of dobutamine on left ventriculoarterial (VA) coupling and mechanical efficiency in acutely ischemic pigs. Experiments were performed in 12 pigs in which vascular properties, including peripheral resistance (R-2), compliance (C), and arterial elastance (E-a), were estimated with a windkessel model, and left ventricular (LV) function by the slope (E-es) of the end-systolic pressure-volume relationship (ESPVR) and stroke work (SW). VA coupling was defined as E-es/E-a, and mechanical efficiency as SW/pressure-volume area (PVA). In all animals, the left anterior descending coronary artery was ligated after basal measures. The animals were then randomly divided into 2 groups: group CTRL (n ...
Increased regional and global myocardial contractility measured by low-dose dobutamine echocardiography/MRI and increased myocardial perfusion measured by adenosine nuclear stress testing ...
Aim of study - Performing the pharmaco-economical analysis «cost/efficiency» of the levosimendane treatment in patients with decompensated, severe CHF, based on data from the study LIDO. Methodology. The CEA analysis: dobutamine vs. levosimendane. Results. Estimations showed that the mean cost of 6-month levosimendane treatment was higher than the dobutamine treatment. The cost of treatment per patient was 73,115 rub. ($2,565) and 8,985 rub. ($312) for levosimendane and dobutamine, respectively. The additional expenses were related with the higher price of levosimendane. The other expenses were similar in both groups. In the dobutamine group major expenses were related with hospitalization while in the levosimendane group - the cost of the drug itself. The levosimendane treatment increased the life expectancy with the annual 3% discounting of 0.35 years. In the Russian Federation, this provides an incremental (added) «cost/efficiency» ratio (ICER) of 183,228 rub. ($6,429) for each prevented ...
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Patient is presenting to the outpatient department with atypical angina pectoris. Risk factors are arterial hypertension and hyperlipoproteinemia. Ambiguous exercise ECG due to left ventricular hypertrophy. Stress MR imaging was ordered due to insufficient echocardiographic image quality. MR imaging consisted of wall motion at rest, adenosine stress perfusion (140µg adenosine /kg body weight for 4 minutes, 0.05 mmol Gd-DTPA-BOPTA/kg body weight), rest perfusion after 10 minutes (0.05 mmol Gd-DTPA-BOPTA/kg body weight), and late Gd enhancement after 10 minutes. Wall motion showed a resting wall motion abnormality basal and equatorial inferior and inferolateral (Figure 1). Perfusion imaging showed an adenosine induced defect in the apical anterior, apical septal, apical inferior and equatorial septal segments (Figure 2=rest; Figure 3=stress). Basal and equatorial inferolateral hypoperfusion is suspected also in the resting perfusion images. Late Gd enhancement shows inferior and inferolateral ...
Our study is the first prospective evaluation using a comprehensive DSCMR examination of patients with LBBB for the diagnosis of CAD. Regarding our primary hypothesis, we have shown that DSCMR is a safe procedure that has a higher diagnostic accuracy than DSE does. Additionally, we have shown that there is an incremental benefit in diagnostic accuracy in using a comprehensive examination including CMR cine imaging, first-pass stress perfusion, and LGE over using CMR cine imaging alone.. The prevalence of LBBB increases with age (up to around 17% at the age of 80 years in a Northern European population), and it is known to confer an adverse prognosis, at least in part due to the risk of cardiac death (2-4). The prevalence of CAD in patients with LBBB is thought to be between 30% and 50%; therefore, given the poor prognosis of LBBB, it would be beneficial to identify those who may benefit from revascularization (19).. Presently, however, diagnosis of CAD in patients with LBBB is difficult. ...
I think whats interesting about this case study is it demonstrates the limitations of the ECG if trying to estimate infarct size. We see only two Q waves in the inferior leads, and yet perhaps more RWMAs on echo than the ECG suggests. Of course, as already mentioned above, the absence of Q waves could simply imply that a non-Q wave infarction has taken place, that previous Q waves have resolved, or that infarction has occurred in areas that are electrically silent - the latter seems to be particularly true for the posterior and some of the lateral segments. Another reason may be ischaemic hibernating myocardium; this is similar to myocardial stunning in the sense that it exhibits resting wall motion abnormalities due to coronary disease, which then improves if the flow of blood is restored. I try not to get these two terms mixed up, so I always think of "stunning" as being nearer to the event [of an acute MI] lasting only for a short period of time following reperfusion, and "hibernation" as a ...
Université de Liège - ULg , Département clinique des animaux de compagnie et des équidés , Département clinique des animaux de compagnie et des équidés ,] ...
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For EKG, there is no need to stop beta blocker. Yes, for Dobutamine stress echocardiogram, beta blocker needs to be stopped three
Septic shock is a medical emergency which requires asupportive treatment with vasoactive agents to restoreadequate blood pressure and tissue perfusion.
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The term myocardial "viability" in chronic left ventricular (LV) dysfunction due to coronary artery disease has been interpreted in multiple ways by clinicians and imagers alike. The classic definition assesses whether or not the myocardial tissue under consideration is alive or dead. However, more often we have used the term to address whether or not the tissue would recover function, especially after revascularization. The variability of imaging definitions of viability further adds to the problem. The imaging definition of viability depends upon the eye of the beholder. For example, an echocardiographer defines viability as a preserved contractile response to low doses of dobutamine (LDD) or inotropic reserve. Those performing single-photon emission computed tomography (SPECT) define viability by the absolute number of counts of myocardial perfusion tracers across a segment of myocardium, or by the demonstration of redistribution of radiotracer in the region of interest at rest. Positron ...
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A type of dyssynergy characterized by the lack of the ability to smoothly perform the elements of a voluntary movement in the appropriate order and speed. [HPO:probinson]
Detecting viable myocardium and predicting functional improvement: comparisons of positron emission tomography, rest-redistribution thallium-201 single-photon emission computed tomography (SPECT), exercise thallium-201 reinjection SPECT, I-123 BMIPP SPECT and dobutamine stress echocardiography ...