scholarly journals Inverted Takotsubo Cardiomyopathy Induced by Dobutamine Stress Echocardiography with Atypical Presentation

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Christian Cadeddu ◽  
Silvio Nocco ◽  
Fabio Cadeddu ◽  
Martino Deidda ◽  
Pierpaolo Bassareo ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Rare Case ◽  
Stress Echocardiography ◽  
Troponin I ◽  
Dobutamine Stress Echocardiography ◽  
Complete Recovery ◽  
Dobutamine Stress ◽  
Atypical Presentation ◽  
Takotsubo Syndrome ◽  
Chest Discomfort

A 48-year-old woman was scheduled by our lab to perform a standard dobutamine/atropine stress echocardiogram. During the test, the patient referred to a slight chest discomfort and developed a progressive left ventricle akinesia of all midbasal LV segments, thus mimicking a midbasal ballooning. ECG persisted without significant abnormalities and with no raise of Troponin I. Coronary angiography showed normal coronary arteries and ventriculography a severe EF reduction and apical hypercontractility. Echocardiography showed a progressive improvement with a complete recovery 48 hours later. This is a rare case of inverted takotsubo syndrome induced by dobutamine stress echocardiography that occurred with atypical presentation.

Abstract 2086: Usefulness of Pneumatic Lower Extremity Compression During Dobutamine Stress Echocardiography

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Hyung-Kwan Kim ◽  
Sung-A Chang ◽  
Jin-Shik Park ◽  
Yong-Jin Kim ◽  
Joo-Hee Zo ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Stress Echocardiography ◽  
Positive Response ◽  
Dobutamine Stress Echocardiography ◽  
False Negative ◽  
Lower Extremities ◽  
Wall Stress ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Myocardial Oxygen Demand

Background Afterload is expected to increase with pneumatic compression of the lower extremities. Therefore, left ventricular (LV) wall stress which is the most important factor determining myocardial oxygen demand will also increase, leading to an increase in sensitivity of dobutamine stress echocardiography (DSE) or shortened time to positive response.The purpose of this study was to evaluate the effect of pneumatic compression of lower extremities on the diagnostic accuracy of DSE. Methods In 40 patients who underwent DSE and were anticipating coronary angiography, DSE was repeated with the pneumatic compression (100mmHg) of lower extremities (DSEcomp) prior to coronary angiography. Sensitivity and specificity of DSE and DSEcomp were determined based on the coronary angiographic finding. Results All patients tolerated pneumatic compression of the lower extremities during the tests. LV end-systolic volume (p=0.042) and end-systolic wall stress (p=0.036) were significantly greater in the DSEcomp than DSE. In 3 patients with false negative results in DSE, DSEcomp showed positive responses, demonstrating a significant increase in sensitivity from 75% to 94% (p=0.045). Only 1 patient with true negative result in DSE was interpreted as showing positive response in DSEcomp, resulting in a decrease in specificity from 88% to 83% (p=NS). In 11 of 13 patients with true positive results both in DSE and DSEcomp, positive responses were seen at least 1 stage earlier in DSEcomp compared to DSE. Conclusions Pneumatic compression of lower extremities increases the sensitivity of DSE and shortens the time to positive response.

scholarly journals Can annual survellance coronary angiography after heart transplantation be substituted by noninvasive dobutamine stress echocardiography?

1996 ◽  
Vol 27 (2) ◽  
pp. 283 ◽  
Author(s):  
Christoph H. Spes ◽  
Harald Mudra ◽  
Susanne D. Schnaack ◽  
Volker Klauss ◽  
Florian M. Reichie ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Heart Transplantation ◽  
Stress Echocardiography ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress

scholarly journals Accuracy of global and regional longitudinal strain at peak of dobutamine stress echocardiography to detect significant coronary artery disease

2021 ◽  
Author(s):  
Federica Ilardi ◽  
Ciro Santoro ◽  
Patrick Maréchal ◽  
Raluca Dulgheru ◽  
Adriana Postolache ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Stress Echocardiography ◽  
Longitudinal Strain ◽  
Dobutamine Stress Echocardiography ◽  
Significant Coronary Artery Disease ◽  
Strain Analysis ◽  
Peak Stress ◽  
Dobutamine Stress ◽  
Regional Wall

AbstractDobutamine stress echocardiography (DSE) is sensitive but subjective diagnostic tool to detect inducible ischemia. Nowadays, speckle tracking allows an objective quantification of regional wall function. We aimed to investigate the feasibility and accuracy of global (GLS) and regional longitudinal strain (RLS) during DSE to detect significant coronary stenosis (SCS). We conducted a prospective observational multicenter study including patients undergoing DSE for suspected SCS. 50 patients with positive DSE underwent coronary angiography. Besides visual regional wall motion score index (WMSI), GLS and RLS were determined at rest and at peak stress by Automated Function Imaging. DSE GLS feasibility was 96%. Among 35 patients with SCS, 12 patients were affected by multivessel disease, 18 had stenosis of left anterior descending artery (LAD), 18 of left circumflex (LCX) and 15 of right coronary artery (RCA). At peak stress, both GLS reduction (p = 0.037) and WMSI worsening (p = 0.04) showed significant agreement with coronary angiography for detecting SCS. When single lesion was considered, peak stress GLS and LAD RLS were lower in the obstructed LAD regions than in normo-perfused territories (17.4 ± 5.5 vs. 20.5 ± 4.4%, p = 0.03; 17.1 ± 7.6 vs. 21.6 ± 5.5%, p < 0.02, respectively). Furthermore, the addition of RLS to regional WMSI was able to improve accuracy in LAD SCS prediction (AUC 0.68, p = 0.037). Conversely, in presence of LCX or RCA SCS, LS was less accurate than WMSI at peak stress. In conclusion, DSE strain analysis is feasible and may improve prediction of LAD SCS, whereas regional WMSI assessment performs better in presence of SCS of LCX and RCA.

Sign in / Sign up

Export Citation Format

Share Document