title: Feasibility, safety and tolerability of accelerated dobutamine stress echocardiography.
abstract: A continuous infusion of a single high dose of dobutamine has been, recently, suggested as a simple and effective protocol of stress echocardiography. The present study assesses the feasibility, safety, and tolerability of an accelerated dobutamine stress protocol performed in patients with suspected or known coronary artery disease. Two hundred sixty five consecutive patients underwent accelerated dobutamine stress echocardiography: the dobutamine was administered at a constant dose of 50 microg/kg/min for up to 10 minutes. The mean weight-adjusted cumulative dose of dobutamine used was 330 +/- 105.24 microg/kg. Total duration of dobutamine infusion was 6.6 +/- 2.1 min. Heart rate rose from 69.9 +/- 12.1 to 123.1 +/- 22.1 beats/min at peak with a concomitant change in systolic blood pressure (127.6 +/- 18.1 vs. 167.6 +/- 45.0 mmHg). Dobutamine administration produced a rapid increase in heart rate (9.4 +/- 5.9 beats/min2). The side effects were similar to those described with the standard protocol; the most common were frequent premature ventricular complexes (21.5%), frequent premature atrial complexes (1.5%) and non sustained ventricular tachycardia (1.5%); among non cardiac symptoms the most frequent were nausea (3.4%), headache (1.1%) and symptomatic hypotension (1.1%). No major side effects were observed during the test. Our data demonstrate that a continous infusion of a single high dose of dobutamine is a safe and well tolerated method of performing stress echocardiography in patients with suspected or known coronary artery disease. This new protocol requires the administration of lower cumulative dobutamine dose than standard protocol and results in a significant reduction in test time.
authors.affiliation: Cardiodiagnostica non invasiva, Department of Cardiology and Cardiovascular Surgery, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy. giovanni.minardi@libero.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Minardi
authors.forename: Carla
authors.initials: C
authors.lastname: Manzara
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pulignano
authors.forename: Paolo G
authors.initials: PG
authors.lastname: Pino
authors.forename: Herribert
authors.initials: H
authors.lastname: Pavaci
authors.forename: Martina
authors.initials: M
authors.lastname: Sordi
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004280:Dobutamine / Q000008:administration & dosage*; D025401:Echocardiography, Stress / Q000379:methods*; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine