Dobutamine stress echocardiography is a well-established method to assess coronary artery disease, of which sensitivity has been enhanced by adding atropine at the end of the protocol. Individuals with glaucoma, a disease with a high prevalence in patients with cardiac diseases older than 40 years, cannot benefit from the use of atropine as it is contraindicated for this group of patients. Additionally, these individuals are often treated with topical betablockers (eye drops), which can have systemic effects by decreasing cardiac frequency, blood pressure and pulmonary capacity. The aim of our study was to verify whether a possible systemic effect caused by the use of these eye drops, yielding a low chronotropic response, could result in inconclusive dobutamine stress echocardiography in patients with glaucoma.
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http://dx.doi.org/10.1590/s0066-782x2007001300010 | DOI Listing |
Echocardiography
February 2025
Department of Cardiology, MedStar Georgetown University Hospital, Washington, DC, USA.
Objective: This study evaluated the safety and efficacy of isoproterenol administration as an adjunct for achievement of target heart rate (HR) during dobutamine stress echocardiography (DSE).
Background: In DSE, optimal accuracy is achieved when a target HR of 85% of maximal predicted heart rate (MPHR) is attained. Although rarely studied, intravenous isoproterenol has been used as an adjunct therapy to dobutamine and atropine to increase chronotropic response during pharmacologic stress testing.
J Cardiol Cases
October 2024
Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Unlabelled: Stress-induced cardiomyopathy is a condition of acute myocardial suppression following an abrupt release of endogenous catecholamines after emotional or physical stress. The exact mechanism is unknown but there are reports of a similar clinical presentation after injection of exogenous catecholamines such as beta agonists. We report a rare type of stress-induced cardiomyopathy following injection of dobutamine during a diagnostic stress echocardiography.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Anomalous aortic origin of coronary artery can lead to ischemia. Due to the limitations of invasive catheterization dobutamine stress testing, an alternative noninvasive approach is desired. A 65-year-old woman with atypical chest pain was referred for coronary computed tomography angiography.
View Article and Find Full Text PDFAm J Physiol Heart Circ Physiol
January 2025
Weatherhead P.E.T. Imaging Center, McGovern Medical School at UTHealth, Houston, Texas, USA.
An increasing number of procedures over the past two decades for aortic stenosis (AS) reflects the combination of an aging population and less invasive transcatheter options. As a result, the hemodynamics of the aortic valve (AV) have gained renewed interest to understand its behavior and to optimize patient selection. We studied the hemodynamic relationship between pressure loss (ΔP) and transvalvular flow (Q) of the normal AV as well as the impact of a variable supravalvular stenosis.
View Article and Find Full Text PDFCureus
December 2024
Cardiovascular Surgery, Ayase Heart Hospital, Tokyo, JPN.
Subvalvular aortic stenosis typically manifests at a young age and rarely presents in adulthood. It may cause left ventricular outflow tract stenosis, which requires surgical treatment in severe cases. The coexistence of discrete subvalvular aortic stenosis and quadricuspid aortic valve is a highly unusual finding.
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