Dobutamine pharmacokinetics during dobutamine stress echocardiography

The American Journal of Cardiology
A L DalyM A Supiano

Abstract

Many patients fail to achieve target heart rate during dobutamine stress echocardiography (DSE). We evaluated the pharmacokinetics of dobutamine during DSE to determine whether patients with an impaired chronotropic response have higher rates of dobutamine clearance and consequently relatively lower plasma dobutamine levels. Plasma dobutamine levels, heart rate, and left ventricular (LV) ejection fraction (EF) were measured in 13 male patients referred for DSE at baseline and at the end of stepped 3-minute dobutamine infusions of 5, 10, 20, and 30 microg/kg/min. Dobutamine levels increased with doses: 27 +/- 10, 111 +/- 17, 275 +/- 17, and 403 +/- 28 ng/ml (mean +/- SEM). There was no relation observed between the plasma dobutamine level achieved at the 30-microg infusion dose and the increase in heart rate from baseline (r = 0.066; p = 0.83). Baseline LVEF and a measure of chronotropic beta responsivity were identified as independent predictors of dobutamine clearance, together accounting for 73% of the variance in dobutamine clearance. In conclusion, (1) there is a dose-dependent increase in plasma dobutamine levels during DSE, (2) dobutamine clearance is positively related to baseline LVEF and is partially mediated by a beta...Continue Reading

References

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Citations

Nov 23, 2007·Cardiovascular Ultrasound·Giovanni MinardiMartina Sordi
Feb 10, 2011·European Journal of Clinical Pharmacology·Anna BanaśMarek Droździk
Jan 26, 2008·Obesity Surgery·Stamatios LerakisRandolph P Martin
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Mar 17, 2006·Critical Care Medicine·Lucienne C LemaireMichael Heesen
Dec 19, 2013·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Ashish SinghalAshokkumar Jain

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