[Feasibility and safety of dobutamine/atropine echocardiography following acute myocardial infarct].
BACKGROUND
Due to the increased utilization of this test for the evaluation of chest pain and for prognostic stratification in patients with a recent myocardial infarction, the results of 235 consecutive tests have been analyzed to evaluate the incidence and clinical significance of side effects induced by dobutamine. A potential limitation to the clinical utilization of dobutamine stress echocardiography is the higher incidence of side effects comparison with to other non invasive tests for the diagnosis of coronary artery disease reported by some authors.


METHODS
Dobutamine/atropine stress echocardiography was performed in 256 patients affected by acute myocardial infarction. Dobutamine was infused starting with the dose of 5 micrograms/kg/min over 3 minutes with incremental steps of 10-20-30-40 micrograms/kg/min over 3 minutes and atropine, in cases of poor chronotropic response, under 2D-echocardiographic and 12-lead electrocardiographic monitoring.


RESULTS
The test was interrupted only in 4 cases for atrial fibrillation (2 patients) and symptomatic hypotension. Patients were divided according to the absence (G1) or presence (G2) of cardiac arrhythmias during the test. Patients of G2 differred from patients of G1 only in respect of the maximal dose of dobutamine infused and the incidence of a wall motion abnormality in the basal echocardiogram.


CONCLUSIONS
Dobutamine/atropine echo stress test may be considered a safe test for the evaluation of the presence and severity of coronary artery disease in patients with a previous or recent myocardial infarction.
Paventi
S
S
Divisione di Cardiologia, Ospedale Sandro Pertini, Roma.
Biferali
F
F
Ciavatti
M
M
Falcone
M
M
Palamara
A
A
D000208:Acute Disease; D000889:Anti-Arrhythmia Agents; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D001285:Atropine; D002316:Cardiotonic Agents / Q000009:adverse effects; D004280:Dobutamine / Q000009:adverse effects; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000503:physiopathology*; D012307:Risk Factors; D012720:Severity of Illness Index
D000889:Anti-Arrhythmia Agents; D002316:Cardiotonic Agents; D004280:Dobutamine; D001285:Atropine
Fattibilità e sicurezza del test eco-dobutamina/atropina dopo infarto miocardico acuto. Esperienza su 235 pazienti.