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Effect of dobutamine stress on left ventricular systolic and diastolic functions in patients with moderate to severe left ventricular dysfunction. 1998

R B Daggubati, and S Khanal, and M Fallahtafti, and R G Pai
Section of Cardiology, Loma Linda VA Medical Center and Loma Linda University, California, USA.

Dobutamine stress echocardiography (DSE) is increasingly used in patients with moderate and severe left ventricular (LV) dysfunction. However, its effect on central and peripheral hemodynamics and LV function in this patient population is not known. This study investigates the effect of dobutamine stress on LV systolic and diastolic performance and peripheral hemodynamics in 177 consecutive patients undergoing DSE. Sixty-five patients with an LV ejection fraction (EF) of < or =40% were compared with 112 patients with an EF of >40%. Compared with those with EF > 40%, patients with EF < or =40% had a faster heart rate(76 +/- 13 vs 70 +/- 13 bpm, p < 0.001), lower systolic blood pressure (127 +/- 18 vs 133 +/- 20 mm Hg, p < 0.05), lower stroke volume (60 +/- 20 vs 74 +/- 36, p = 0.01), longer LV isovolumic relaxation time (118 +/- 37 vs 108 +/- 25 msec, p < 0.05) and larger LV end-diastolic (57 +/- 9.6 vs 49 +/- 7 mm, p < 0.0001) and end-systolic (46 +/- 10 vs 32 +/- 7.9 mm, p < 0.0001) diameters. They also had a lesser increment in cardiac output (1.5 +/- 1.6 vs 3.2 +/- 4.8 L/min, p = 0.02), a smaller reduction of systolic LV size (-5.3 +/- 4.1 vs -7.0 +/- 4.3 mm, p < 0.05) and a lower propensity to LV cavity obliteration with dobutamine infusion. In conclusion, patients with an EF < or =40% have lower baseline stroke volume, systolic blood pressure, higher heart rate, and longer LV isovolumic relaxation time. They also have a smaller increase in cardiac output, a smaller reduction of LV size, and a lower propensity to LV cavity obliteration with dobutamine stress.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003971 Diastole Post-systolic relaxation of the HEART, especially the HEART VENTRICLES. Diastoles
D004280 Dobutamine A catecholamine derivative with specificity for BETA-1 ADRENERGIC RECEPTORS. It is commonly used as a cardiotonic agent after CARDIAC SURGERY and during DOBUTAMINE STRESS ECHOCARDIOGRAPHY. Dobucor,Dobuject,Dobutamin Fresenius,Dobutamin Hexal,Dobutamin Solvay,Dobutamin-ratiopharm,Dobutamina Inibsa,Dobutamina Rovi,Dobutamine (+)-Isomer,Dobutamine Hydrobromide,Dobutamine Hydrochloride,Dobutamine Lactobionate,Dobutamine Phosphate (1:1) Salt, (-)-Isomer,Dobutamine Tartrate,Dobutamine Tartrate (1:1), (R-(R*,R*))-Isomer,Dobutamine Tartrate (1:1), (S-(R*,R*))-Isomer,Dobutamine, (-)-Isomer,Dobutamine, Phosphate (1:1) Salt (+)-Isomer,Dobutrex,Lilly 81929,Oxiken,Posiject,Dobutamin ratiopharm,Hydrobromide, Dobutamine,Hydrochloride, Dobutamine,Lactobionate, Dobutamine,Tartrate, Dobutamine
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000318 Adrenergic beta-Agonists Drugs that selectively bind to and activate beta-adrenergic receptors. Adrenergic beta-Receptor Agonists,beta-Adrenergic Agonists,beta-Adrenergic Receptor Agonists,Adrenergic beta-Agonist,Adrenergic beta-Receptor Agonist,Betamimetics,Receptor Agonists, beta-Adrenergic,Receptors Agonists, Adrenergic beta,beta-Adrenergic Agonist,beta-Adrenergic Receptor Agonist,Adrenergic beta Agonist,Adrenergic beta Agonists,Adrenergic beta Receptor Agonist,Adrenergic beta Receptor Agonists,Agonist, Adrenergic beta-Receptor,Agonist, beta-Adrenergic,Agonist, beta-Adrenergic Receptor,Agonists, Adrenergic beta-Receptor,Agonists, beta-Adrenergic,Agonists, beta-Adrenergic Receptor,Receptor Agonist, beta-Adrenergic,Receptor Agonists, beta Adrenergic,beta Adrenergic Agonist,beta Adrenergic Agonists,beta Adrenergic Receptor Agonist,beta Adrenergic Receptor Agonists,beta-Agonist, Adrenergic,beta-Agonists, Adrenergic,beta-Receptor Agonist, Adrenergic,beta-Receptor Agonists, Adrenergic
D013599 Systole Period of contraction of the HEART, especially of the HEART VENTRICLES. Systolic Time Interval,Interval, Systolic Time,Intervals, Systolic Time,Systoles,Systolic Time Intervals,Time Interval, Systolic,Time Intervals, Systolic
D015150 Echocardiography, Doppler Measurement of intracardiac blood flow using an M-mode and/or two-dimensional (2-D) echocardiogram while simultaneously recording the spectrum of the audible Doppler signal (e.g., velocity, direction, amplitude, intensity, timing) reflected from the moving column of red blood cells. Doppler Echocardiography,Echocardiography, Continuous Doppler,Echocardiography, Two-Dimensional Doppler,2-D Doppler Echocardiography,2D Doppler Echocardiography,Continuous Doppler Echocardiography,Doppler Echocardiography, 2-D,Doppler Echocardiography, 2D,Doppler Echocardiography, Continuous,Doppler Echocardiography, Two-Dimensional,Echocardiography, 2-D Doppler,Echocardiography, 2D Doppler,Two-Dimensional Doppler Echocardiography,2 D Doppler Echocardiography,Doppler Echocardiography, 2 D,Doppler Echocardiography, Two Dimensional,Echocardiography, 2 D Doppler,Echocardiography, Two Dimensional Doppler,Two Dimensional Doppler Echocardiography
D016022 Case-Control Studies Comparisons that start with the identification of persons with the disease or outcome of interest and a control (comparison, referent) group without the disease or outcome of interest. The relationship of an attribute is examined by comparing both groups with regard to the frequency or levels of outcome over time. Case-Base Studies,Case-Comparison Studies,Case-Referent Studies,Matched Case-Control Studies,Nested Case-Control Studies,Case Control Studies,Case-Compeer Studies,Case-Referrent Studies,Case Base Studies,Case Comparison Studies,Case Control Study,Case Referent Studies,Case Referrent Studies,Case-Comparison Study,Case-Control Studies, Matched,Case-Control Studies, Nested,Case-Control Study,Case-Control Study, Matched,Case-Control Study, Nested,Case-Referent Study,Case-Referrent Study,Matched Case Control Studies,Matched Case-Control Study,Nested Case Control Studies,Nested Case-Control Study,Studies, Case Control,Studies, Case-Base,Studies, Case-Comparison,Studies, Case-Compeer,Studies, Case-Control,Studies, Case-Referent,Studies, Case-Referrent,Studies, Matched Case-Control,Studies, Nested Case-Control,Study, Case Control,Study, Case-Comparison,Study, Case-Control,Study, Case-Referent,Study, Case-Referrent,Study, Matched Case-Control,Study, Nested Case-Control

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