Early deterioration followed by improvement in contractility during dobutamine stress echocardiography: An unusual response.
In 2 patients with severe proximal coronary artery stenosis and normal wall motion in this territory, we observed marked wall motion abnormalities with low and intermediate doses of dobutamine, followed by marked improvement with continued dobutamine infusion. This unusual response suggests ischemic preconditioning and recruitment of coronary collaterals and would be recognized only by monitoring of images obtained at all stages of dobutamine infusion.
Juracan
E M
EM
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
Freeman
W K
WK
Pellikka
P A
PA
D000368:Aged; D002316:Cardiotonic Agents / Q000008:administration & dosage; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004280:Dobutamine / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects*
D002316:Cardiotonic Agents; D004280:Dobutamine