Detail
Article
Online article
FT
Medvik - BMC
  • Something wrong with this record ?

Myocardial injury in stress echocardiography: Comparison of dobutamine, dipyridamole and dynamic stressors-single center study

K. Medilek, L. Zaloudkova, A. Borg, L. Brozova, J. Stasek

. 2022 ; 39 (9) : 1171-1179. [pub] 20220811

Language English Country United States

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc22024550

OBJECTIVES: In stress echocardiography (SE), dipyridamole (DIP) and dynamic stress (ExSE) are reported as being safer than dobutamine stress echocardiography (DSE). We investigated whether these commonly used stressors cause myocardial injury, measured by high sensitivity troponin T (hsTnT). METHODS: One hundred and thirty five patients (DSE n = 46, ExsE n = 46, DIP n = 43) with negative result of SE were studied. The exclusion criteria were known ischaemic heart disease (IHD), baseline wall motion abnormalities, left ventricle systolic dysfunction/regional wall motion abnormalities, septum/posterior wall ≥13 mm, diabetes/pre-diabetes, baseline hsTnT level ≥14 ng/L, baseline blood pressure ≥160/100 mmHg, peak pulmonary pressure ≥45mmHg, eGFR <1ml/s/1.73m2 , more than mild to moderate valvular disease and dobutamine side effects. HsTnT was measured before and 180 minutes after the test. RESULTS: All patients had low pre-test probabilities of having obstructive IHD. HsTnT increased in DSE, less so in ExSE, and was unchanged in the DIP group (∆hsTnT 9.4 [1.5-58.6], 1.1 [-0.9-15.7], -0.1 [-1.4-2.1] ng/L, respectively, p<0.001). In DSE, the ∆hsTnT was associated with peak dobutamine dose (r = 0.30, p = 0.045), test length (r = 0.43, p = 0.003) and atropine use (p<0.001). In ExSE, the hsTnT increase was more likely in females (p = 0.012) and the elderly (>65 years) (r = 0.32, p = 0.03); no association was found between atropine use (p = 0.786) or test length and ∆hsTnT (r = 0.10, p = 0.530). CONCLUSIONS: DSE is associated with myocardial injury in patients with negative SE, no injury was observed in DIP and only mild case in ExSE. Whether myocardial injury is causative of the higher reported adverse event rates in DSE remains to be determined.

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc22024550
003      
CZ-PrNML
005      
20221031100852.0
007      
ta
008      
221017s2022 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1111/echo.15411 $2 doi
035    __
$a (PubMed)35950564
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Medilek, Karel $u Department of Cardio-Angiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic $u Faculty of Medicine Hradec Kralove, Charles University Prague, Hradec Kralove, Czech Republic
245    10
$a Myocardial injury in stress echocardiography: Comparison of dobutamine, dipyridamole and dynamic stressors-single center study / $c K. Medilek, L. Zaloudkova, A. Borg, L. Brozova, J. Stasek
520    9_
$a OBJECTIVES: In stress echocardiography (SE), dipyridamole (DIP) and dynamic stress (ExSE) are reported as being safer than dobutamine stress echocardiography (DSE). We investigated whether these commonly used stressors cause myocardial injury, measured by high sensitivity troponin T (hsTnT). METHODS: One hundred and thirty five patients (DSE n = 46, ExsE n = 46, DIP n = 43) with negative result of SE were studied. The exclusion criteria were known ischaemic heart disease (IHD), baseline wall motion abnormalities, left ventricle systolic dysfunction/regional wall motion abnormalities, septum/posterior wall ≥13 mm, diabetes/pre-diabetes, baseline hsTnT level ≥14 ng/L, baseline blood pressure ≥160/100 mmHg, peak pulmonary pressure ≥45mmHg, eGFR <1ml/s/1.73m2 , more than mild to moderate valvular disease and dobutamine side effects. HsTnT was measured before and 180 minutes after the test. RESULTS: All patients had low pre-test probabilities of having obstructive IHD. HsTnT increased in DSE, less so in ExSE, and was unchanged in the DIP group (∆hsTnT 9.4 [1.5-58.6], 1.1 [-0.9-15.7], -0.1 [-1.4-2.1] ng/L, respectively, p<0.001). In DSE, the ∆hsTnT was associated with peak dobutamine dose (r = 0.30, p = 0.045), test length (r = 0.43, p = 0.003) and atropine use (p<0.001). In ExSE, the hsTnT increase was more likely in females (p = 0.012) and the elderly (>65 years) (r = 0.32, p = 0.03); no association was found between atropine use (p = 0.786) or test length and ∆hsTnT (r = 0.10, p = 0.530). CONCLUSIONS: DSE is associated with myocardial injury in patients with negative SE, no injury was observed in DIP and only mild case in ExSE. Whether myocardial injury is causative of the higher reported adverse event rates in DSE remains to be determined.
650    _2
$a senioři $7 D000368
650    _2
$a deriváty atropinu $7 D001286
650    _2
$a kardiotonika $7 D002316
650    12
$a nemoci koronárních tepen $x komplikace $7 D003324
650    _2
$a dipyridamol $7 D004176
650    _2
$a dobutamin $7 D004280
650    _2
$a echokardiografie $7 D004452
650    _2
$a zátěžová echokardiografie $7 D025401
650    _2
$a zátěžový test $7 D005080
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a lidé $7 D006801
650    12
$a ischemická choroba srdeční $x komplikace $7 D017202
650    _2
$a senzitivita a specificita $7 D012680
655    _2
$a časopisecké články $7 D016428
700    1_
$a Zaloudkova, Lenka $u Department of Clinical Biochemistry, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
700    1_
$a Borg, Alexander $u Department of Cardiology, Mater Dei Hospital, Triq Dun Karm, L-Imsida MSD, Malta $u University of Malta, Msida MSD, Malta
700    1_
$a Brozova, Lucie $u Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
700    1_
$a Stasek, Josef $u Department of Cardio-Angiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic $u Faculty of Medicine Hradec Kralove, Charles University Prague, Hradec Kralove, Czech Republic
773    0_
$w MED00001491 $t Echocardiography $x 1540-8175 $g Roč. 39, č. 9 (2022), s. 1171-1179
856    41
$u https://pubmed.ncbi.nlm.nih.gov/35950564 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20221017 $b ABA008
991    __
$a 20221031100848 $b ABA008
999    __
$a ok $b bmc $g 1854331 $s 1175840
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2022 $b 39 $c 9 $d 1171-1179 $e 20220811 $i 1540-8175 $m Echocardiography $n Echocardiography $x MED00001491
LZP    __
$a Pubmed-20221017

Find record

Citation metrics

Archiving options