CV Outcomes During DSE
None of the 128 patients studied had regional wall motion abnormalities
prior to dobutamine infusion. All patients achieved ≥ 85% of target
heart rate. One patient was found to have dobutamine-induced hypokinesis
of mid-anterior and mid anteroseptal LV segments in the group that did
not receive intravenous contrast. No dobutamine-induced regional wall
motion abnormalities were noted in the group that received intravenous
contrast enhancement. Coronary angiography was performed on the patient
with a positive stress test and showed high-grade stenosis of the
mid-portion of the left anterior descending coronary artery.
Drug-eluting stent placement was performed without incident. No patient
in the group that received intravenous contrast had DSE findings
suggestive of myocardial ischemia. No patient had dobutamine-induced
global LV dilatation or systolic dysfunction or a hyper-dynamic response
with LV outflow tract obstruction. No patient developed severe
hypertension. Two patients developed mild transient hypotension that
resolved spontaneously, 1 in each group (p=0.965). Isolated atrial and
ventricular premature beats occurred in multiple patients in both the
intravenous contrast and non-intravenous contrast groups. There were no
episodes of ventricular tachycardia, atrial fibrillation, or other
Alpert
supraventricular tachyarrhythmias. Three patients required intravenous
metoprolol due to persistent sinus tachycardia after completion of the
DSE protocol.