PURPOSE: In subjects without underlying cardiac disease dobutamine is known to enhance systolic LV function and LV relaxation. As end-systolic (ES) and end-diastolic (ED) volumes (V) can be derived from gated SPECT we intent to study these volumes and their response to dobutamine in order to have a better understanding of the mechanism by which stroke volume (SV) increases during dobutamine infusion. We intent to do this in normal controls and in young diabetic subjects. METHODS: After injection of sestamibi, serial gated SPECT were obtained at baseline, and during low doses of dobutamine infusion in 12 asymptomatic type I diabetic patients, and in 12 age matched controls. LV EDV, ESV, SV and EF were calculated with the QGS program. RESULTS: Gated SPECT showed comparable LV EF and SV in both groups at rest. There was a significant increase in LVEF and SV during dobutamine infusion but in the diabetic patients the increase in SV was due to a decrease in ESV from 25+/-5 to 20+/-6 ml/m2 (p=0.002) and no change in EDV. In normal controls, the increase in EF was due to an increase in EDV from 69+/-10 to 73+/-12 ml/m2 (p=0.002) with no significant change in ESV. CONCLUSION: These data confirm the presence of subclinical abnormalities of diastolic function in asymptomatic type I diabetic patients and show differences in adaptation to inotropic stimulation in order to preserve the increase in stroke volume and LV ejection fraction.
PURPOSE: In subjects without underlying cardiac diseasedobutamine is known to enhance systolic LV function and LV relaxation. As end-systolic (ES) and end-diastolic (ED) volumes (V) can be derived from gated SPECT we intent to study these volumes and their response to dobutamine in order to have a better understanding of the mechanism by which stroke volume (SV) increases during dobutamine infusion. We intent to do this in normal controls and in young diabetic subjects. METHODS: After injection of sestamibi, serial gated SPECT were obtained at baseline, and during low doses of dobutamine infusion in 12 asymptomatic type I diabeticpatients, and in 12 age matched controls. LV EDV, ESV, SV and EF were calculated with the QGS program. RESULTS: Gated SPECT showed comparable LV EF and SV in both groups at rest. There was a significant increase in LVEF and SV during dobutamine infusion but in the diabeticpatients the increase in SV was due to a decrease in ESV from 25+/-5 to 20+/-6 ml/m2 (p=0.002) and no change in EDV. In normal controls, the increase in EF was due to an increase in EDV from 69+/-10 to 73+/-12 ml/m2 (p=0.002) with no significant change in ESV. CONCLUSION: These data confirm the presence of subclinical abnormalities of diastolic function in asymptomatic type I diabeticpatients and show differences in adaptation to inotropic stimulation in order to preserve the increase in stroke volume and LV ejection fraction.
Authors: I I Albanna; S M Eichelberger; P R Khoury; S A Witt; D A Standiford; L M Dolan; S R Daniels; T R Kimball Journal: J Am Soc Echocardiogr Date: 1998-04 Impact factor: 5.251
Authors: P A Pellikka; V L Roger; R B McCully; D W Mahoney; K R Bailey; J B Seward; A J Tajik Journal: Am J Cardiol Date: 1995-11-01 Impact factor: 2.778