PMID: 9137218May 1, 1997Paper

Evolution of dobutamine echocardiography protocols and indications: safety and side effects in 3,011 studies over 5 years

Journal of the American College of Cardiology
M A Secknus, T Marwick


This study sought to document the safety of dobutamine stress echocardiography as it has evolved at a single center and to define predictors of adverse events. The indications and protocol for dobutamine stress testing have evolved over 5 years of clinical use, but the influence of these changes on the safety and side effects of the test is undefined. Over 5 years, 3,011 consecutive dobutamine stress studies were performed in 2,871 patients, using an incremental protocol from 5 to 40 micrograms/kg body weight per min in 3-min stages, followed by atropine or an additional stage with 50 micrograms/kg per min, if required. Clinical data were gathered prospectively, and hemodynamic and echocardiographic findings were recorded at each stage, including recovery. Dobutamine echocardiography was defined as positive for ischemia in the presence of new or worsening wall motion abnormalities; in the absence of ischemia, failure to attain 85% of age-predicted maximal heart rate was identified as a nondiagnostic result. Studies were performed for risk assessment (70%) and symptom evaluation (30%); over the study period, there was an increment in the use of dobutamine echocardiography for preoperative evaluation. Most tests (n = 2,194 [73%])...Continue Reading

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