This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Ueda, T. Articles by Kohno, M. Search for Related Content PubMed PubMed Citation Articles by Ueda, T. Articles by Kohno, M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Low Blood Pressure Social Bookmarking                         What's this?

Hypotension and Functional Left Ventricular Obstruction During Dobutamine Stress Echocardiography

Two Case Reports

Hyogo and Kagawa, Japan

Katsufumi Mizushige, MD

Hyogo and Kagawa, Japan

Kazushi Yukiiri, MD

Hyogo and Kagawa, Japan

Kazufumi Watanabe, MD

Hyogo and Kagawa, Japan

Masakazu Kohno, MD

Hyogo and Kagawa, Japan

Although hypotension during dobutamine stress echocardiography has been reported, the mechanism of this response is still controversial. In two patients, a 72-year-old woman and 64-year-old man, with exercise-induced ST-T change, continuous-wave Doppler examination of the left ventricular cavity was performed at baseline and peak dobutamine infusion. No echocar diographic abnormalities at rest or angiographic coronary lesions were observed in either patient. The intracavitary pressure gradient at peak dosage of dobutamine for both patients was 121 mm Hg and 100 mm Hg, and was reproducibly confirmed by cardiac catheterization. During dobutamine infusion, echocardiography or left ventriculography revealed that papillary muscle motion was dramatically augmented by dobutamine and mid-left ventricular obstruction was produced at the systolic phase. Although blood pressure response improved following β-blocker treatment, intracavitary pressure gradient during dobutamine infusion remained the same. A hypotensive response during dobutamine stress echocardiography may be produced by the development of dynamic intraventricular obstruction and a vasodepression reflex. The exercise-induced electrocardiographic changes may have been related to the systolic pressure augmentation in the mid-to-apical left ventricular cavity.

Angiology, Vol. 52, No. 7, 489-492 (2001)
DOI: 10.1177/000331970105200708


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?