DOBUTAMINE STRESS ECHOCARDIOGRAPHY IN PATIENTS AFTER HEART-TRANSPLANTATION - INITIAL EXPERIENCE

Citation
E. Gunther et al., DOBUTAMINE STRESS ECHOCARDIOGRAPHY IN PATIENTS AFTER HEART-TRANSPLANTATION - INITIAL EXPERIENCE, Zeitschrift fur Kardiologie, 84(5), 1995, pp. 411-418
Citations number
42
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiac & Cardiovascular System
Journal title
ISSN journal
0300-5860
Volume
84
Issue
5
Year of publication
1995
Pages
411 - 418
Database
ISI
SICI code
0300-5860(1995)84:5<411:DSEIPA>2.0.ZU;2-Z
Abstract
Cardiac allograft vasculopathy (CAV) has become one of the primary obs tacles to long-term survival of patients after heart transplantation. The low sensitivity of currently available noninvasive tests still rem ains a problem in the early diagnosis of the disease. To assess the fe asibility, safety, and usefulness of dobutamine stress echocardiograph y as a noninvasive predictor of cardiac allograft vasculopathy, we exa mined 20 patients (3 female) 3-35 months after orthotopic heart transp lantation. All patients underwent coronary angiography within 2 weeks of dobutamine stress echocardiography. Results: 89 % of the segments e xamined could be evaluated for wall motion abnormalities. Under increa sing doses of dobutamine (5 to max. 30 mu g/kg/min), heart rate increa sed from 88 +/- 13 bpm to 141 +/- 16 bpm, and systolic blood pressure from 139 +/- 14 mmHg to 154 +/- 28 mm Hg. Two of 4 patients with angio graphically detected CAV developed new wall motion abnormalities under dobutamine; their wall motion score increased from 1.23 +/- 0.22 to 1 .31 +/- 0.24. In the other patients without CAV, the wall motion score remained almost unchanged (1.01 +/- 0.3 to 1.02 +/- 0.4). Dobutamine was well tolerated, and there were no serious complications. Thus, dob utamine stress echocardiography seems to be feasible and safe in patie nts after heart transplantation. Our results suggest that it might be useful for the detection of cardiac allograft vasculopathy. The final determination of its clinical usefulness in the diagnosis of cardiac a llograft vasculopathy needs further extensive investigations.