Dobutamine stress echocardiography identifies patients with angina and dynamic left ventricular outflow obstruction in physiological exercise.
To determine whether patients with no heart disease who develop dynamic left ventricular outflow obstruction (DLVOTO) during dobutamine echocardiography (DE) reproduce the phenomenon during exercise echocardiography (EE), DE and EE were performed in 78 patients (59 +/- 9 years) with effort angina and no alterations in SPECT. Thirty-eight (48.7%) patients had DLVOTO during DE and 15 (19.2%) during EE. This phenomenon during EE was reproducible in 39.4% of the patients with DLVOTO on DE, and 100% of the patients with DLVOTO during EE had it during DE. Independent factors predicting DLVOTO during EE were the LVOT diameter (OR 0.33 (0.14-0.74)) and the left ventricular (LV) mass index (OR 1.05 (1.01-1.08)). No cardiovascular events were noted after 26+/-3 months. The reproducibility of DLVOTO during EE in patients with unexplained angina and with DLVOTO on DE is associated with the size of the LVOT and the LV mass index. The long-term prognosis is excellent.
Cabrera-Bueno
Fernando J
FJ
Department of Cardiology, University Hospital Virgen de la Victoria, Malaga, Spain. fjcabrera@secardiologia.es
Gómez-Doblas
Juan J
JJ
Garcia-Pinilla
Jose M
JM
Montiel-Trujillo
Angel
A
Jiménez-Navarro
Manuel
M
Martinez-Del-Valle
Dolores
D
Jiménez-Hoyuela
Jose M
JM
de Teresa-Galván
Eduardo
E
D000318:Adrenergic beta-Agonists; D000787:Angina Pectoris / Q000150:complications* / Q000000981:diagnostic imaging*; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014694:Ventricular Outflow Obstruction / Q000150:complications* / Q000000981:diagnostic imaging*
D000318:Adrenergic beta-Agonists; D004280:Dobutamine