Tissue Velocity Imaging with Dobutamine Stress Echocardiography–A Quantitative Technique for Identification of Coronary Artery Disease in Patients with Left Bundle Branch Block

2007 ◽  
Vol 20 (7) ◽  
pp. 820-831 ◽  
Author(s):  
Hala Badran Badran ◽  
Mohamed Fahmy Elnoamany ◽  
Mohamed Seteha
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Bundle Branch Block ◽  
Stress Echocardiography ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress ◽  
Bundle Branch Block ◽  
Quantitative Technique ◽  
Velocity Imaging ◽  
Artery Disease

Dobutamine Stress Echocardiography to Detect Inducible Demand Ischemia in Anesthetized Patients with Coronary Artery Disease 

1998 ◽  
Vol 88 (5) ◽  
pp. 1233-1239 ◽  
Author(s):  
Manfred D. Seeberger ◽  
Karl Skarvan ◽  
Peter Buser ◽  
Wolfgang Brett ◽  
Reinhard Rohlfs ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stress Echocardiography ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress ◽  
Noncardiac Surgery ◽  
Severe Coronary Artery Disease ◽  
Inducible Ischemia ◽  
Severe Coronary Artery ◽  
Artery Disease

Background A cardiac risk stratification test that can be performed during operation would be expected to give valuable information for the therapeutic management of patients who need urgent noncardiac surgery. This study was designed to evaluate the feasibility and safety of a dobutamine-atropine stress protocol to detect inducible demand ischemia in anesthetized patients. Methods A standard dobutamine-atropine stress protocol was performed in 80 patients with severe coronary artery disease during fentanyl-isoflurane anesthesia. Biplane transesophageal echocardiography and 12-lead electrocardiography were used to detect induced ischemia. After dobutamine testing, esmolol, nitroglycerin, or both were used to revert ischemia and any hemodynamic changes, as appropriate. Results The protocol detected inducible ischemia or achieved the target heart rate in 75 of the 80 (94%) patients. None of the prospectively defined adverse outcomes, such as cardiovascular collapse, severe ventricular arrhythmia, persistent (> or =5 min) ischemia, or hemodynamic instability, occurred in any of the patients. Ischemia was induced and detected in 73 of the 80 (91%) patients. Conclusion Dobutamine stress echocardiography is feasible in anesthetized patients with severe coronary artery disease. The lack of serious complications and the high sensitivity to detect inducible ischemia in this patient population provide the basis for further evaluation of the safety and diagnostic value of dobutamine stress echocardiography during general anesthesia in larger studies of patients at risk for coronary artery disease undergoing noncardiac surgery.

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