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.