Hemodynamic responses and long-term follow-up results in patients using chronic beta 1-selective and nonselective beta-blockers during dobutamine stress echocardiography.
OBJECTIVE
This study was undertaken to determine to what extent hemodynamic responses to dobutamine infusion between patients using concomitant beta1-selective or nonselective beta-blockers differ and whether this difference affects the long-term prognostic value of dobutamine stress echocardiography with respect to cardiac events.


METHODS
Single center, observational study.


METHODS
A total of 1234 patients using chronic beta-blockers underwent dobutamine stress echocardiography and were prospectively included in the study. Heart rate and blood pressure responses were measured during the dobutamine stress echocardiography protocol. During a median follow-up time of 4 years (range: 0.5-14 years), overall and cardiac mortality and nonfatal myocardial infarction were noted.


RESULTS
A total of 954 and 280 patients were using beta1-selective and nonselective beta-blockers, respectively. During dobutamine stress echocardiography, the heart rate response was significantly higher, systolic and diastolic blood pressure responses were significantly lower and the double product of heart rate and systolic blood pressure was similar in patients using beta1-selective than in patients using nonselective beta-blockers. In patients with and without new wall motion abnormalities during dobutamine stress echocardiography, a similar cardiac event-free survival was observed irrespective of the selectivity of beta-blockers (P=0.9 and 0.3, respectively).


CONCLUSIONS
During dobutamine stress echocardiography, heart rate and blood pressure response was different, but the double product was similar in patients using beta1-selective or nonselective beta-blockers, which may explain why the long-term prognostic value of dobutamine stress echocardiography is similar in these two groups.
Feringa
Harm H H
HH
Department of Anaesthesiology, Erasmus Medical Center, Rotterdam, The Netherlands.
Bax
Jeroen J
JJ
Elhendy
Abdou
A
van Domburg
Ron T
RT
Schouten
Olaf
O
Krenning
Boudewijn
B
Poldermans
Don
D
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D001775:Blood Circulation / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects*; D025401:Echocardiography, Stress; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D011446:Prospective Studies; D018342:Receptors, Adrenergic, beta-1 / Q000187:drug effects*; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D018342:Receptors, Adrenergic, beta-1