BACKGROUND: A decrease in stroke volume during dobutamine-atropine stress echocardiography heralds ischaemia and possible hypotension. Hypotension results from worsening of LV-function (as a result of ischaemia) left ventricular outflow tract obstruction or hypovolemia, while an increase of stroke volume indicates the preservation of myocardial contractile reserve. OBJECTIVE: To assess stroke volume changes during dobutamine stress echocardiography in relation to heart rate and occurrence of ischaemia and to validate a new automated cardiac output measurement device. METHODS: In fifty patients, the stroke volume was assessed using the echocardiographic biplane discs method during a stress echocardiography. These data were reference values for the validation of a new automated cardiac output measurement using the first method as a reference. RESULTS: Stroke volume measured by the biplane discs method and automated cardiac output device decreased from rest to peak stress, respectively, from 54+/-16 to 34+/-9 (63%) ml and 63+/-17 to 38+/-15 (60%) ml (p < 0.001). Stroke volume decreased with increased heart rate and stress-induced ischaemia when assessed by the biplane discs method, but with the automated device it decreased only with increased heart rate. CONCLUSIONS: Both increased heart rate and myocardial ischaemia during dobutamine stress echocardiography cause a reduction of stroke volume. However, the automated device did not detect the effects of stress-induced ischaemia on stroke volume. It appears that the biplane discs method is more sensitive for evaluating the effect of ischaemia.
BACKGROUND: A decrease in stroke volume during dobutamine-atropine stress echocardiography heralds ischaemia and possible hypotension. Hypotension results from worsening of LV-function (as a result of ischaemia) left ventricular outflow tract obstruction or hypovolemia, while an increase of stroke volume indicates the preservation of myocardial contractile reserve. OBJECTIVE: To assess stroke volume changes during dobutamine stress echocardiography in relation to heart rate and occurrence of ischaemia and to validate a new automated cardiac output measurement device. METHODS: In fifty patients, the stroke volume was assessed using the echocardiographic biplane discs method during a stress echocardiography. These data were reference values for the validation of a new automated cardiac output measurement using the first method as a reference. RESULTS:Stroke volume measured by the biplane discs method and automated cardiac output device decreased from rest to peak stress, respectively, from 54+/-16 to 34+/-9 (63%) ml and 63+/-17 to 38+/-15 (60%) ml (p < 0.001). Stroke volume decreased with increased heart rate and stress-induced ischaemia when assessed by the biplane discs method, but with the automated device it decreased only with increased heart rate. CONCLUSIONS: Both increased heart rate and myocardial ischaemia during dobutamine stress echocardiography cause a reduction of stroke volume. However, the automated device did not detect the effects of stress-induced ischaemia on stroke volume. It appears that the biplane discs method is more sensitive for evaluating the effect of ischaemia.
Authors: N B Schiller; P M Shah; M Crawford; A DeMaria; R Devereux; H Feigenbaum; H Gutgesell; N Reichek; D Sahn; I Schnittger Journal: J Am Soc Echocardiogr Date: 1989 Sep-Oct Impact factor: 5.251
Authors: S Carstensen; S M Ali; F V Stensgaard-Hansen; J Toft; S Haunsø; H Kelbaek; K Saunamäki Journal: Circulation Date: 1995-12-15 Impact factor: 29.690
Authors: D Poldermans; P M Fioretti; E Boersma; T Forster; H van Urk; J H Cornel; M Arnese; R T Roelandt Journal: Am J Cardiol Date: 1994-03-01 Impact factor: 2.778