Dobutamine Stress Echocardiography Before and After Coronary Angioplasty Albert J. McNeill, MD, Paolo M. Fioretti, MD, El-SaidM. El-Said,MB, BCh, MS, Alessandro Salustri, MD, Pim J. de Feyter, MD, and Jos R. T. C. Roelandt, MD
Myocardtal functii was assessed by stress echocardiography in 28 patients before and after successful etective coronary angioplasty. Dobutamine stress echocardiography was performed udng up to 40 &g/min, followed by the addition of atropine in 20 patients to achieve 85% of the predicted maximal exercise heart rate. The initial studies were performed 1 day before and the second ones within 3 days (mean 1.3) after angiopiasty. Peak heart rates and systdic blood pressures were the same for the 2 studies. The frequency of dobutamine-induced new wall motion abnormalities decreased from 20 (71%) before to 4 (14%) after angioplasty (p 20 mm Hg from that at rest, or any side effect regardedas being due to dobutamine. Metoprolol was available and usedto reversethe effectsof dobutamine, if they did not revert spontaneouslyand quickly. Angioplaity: Angioplasty was performed by the femoral route using standard equipment and techniques within 1 day of the initial stressechocardiography.Severity of the stenosisbefore and after the procedurewas assessedby either visual or quantitative analysis15without knowledge of the results of the stress echocardiographic tests.Angioplasty was indicated in casesof persistent angina1 symptoms despite medication, and of coronary diseasewith a diameter stenosis LX)%. The result of angioplasty was considered positive if the diameter stenosiswas reduced to
Myocardtal functii was assessed by stress echocardiography in 28 patients before and after successful etective coronary angioplasty. Dobutamine stress echocardiography was performed udng up to 40 &g/min, followed by the addition of atropine in 20 patients to achieve 85% of the predicted maximal exercise heart rate. The initial studies were performed 1 day before and the second ones within 3 days (mean 1.3) after angiopiasty. Peak heart rates and systdic blood pressures were the same for the 2 studies. The frequency of dobutamine-induced new wall motion abnormalities decreased from 20 (71%) before to 4 (14%) after angioplasty (p 20 mm Hg from that at rest, or any side effect regardedas being due to dobutamine. Metoprolol was available and usedto reversethe effectsof dobutamine, if they did not revert spontaneouslyand quickly. Angioplaity: Angioplasty was performed by the femoral route using standard equipment and techniques within 1 day of the initial stressechocardiography.Severity of the stenosisbefore and after the procedurewas assessedby either visual or quantitative analysis15without knowledge of the results of the stress echocardiographic tests.Angioplasty was indicated in casesof persistent angina1 symptoms despite medication, and of coronary diseasewith a diameter stenosis LX)%. The result of angioplasty was considered positive if the diameter stenosiswas reduced to
