一种新的加速多巴酚丁胺负荷超声心动图方案的安全性及并发症预测因素

Safety and predictors of complications with a new accelerated dobutamine stress echocardiography protocol.

作者信息

San Román José Alberto, Sanz-Ruiz Ricardo, Ortega José Ramón, Pérez-Paredes Matías, Rollán María Jesús, Muñoz Ana Cristina, Segura Federico, Jimenez Diego, Carnero Andres, Pinedo Marta, Arnold Roman, Gómez Itziar, Fernández-Aviles Francisco

机构信息

Institute of Heart Sciences (ICICOR), Clinic University Hospital of Valladolid, Valladolid, Spain.

出版信息

J Am Soc Echocardiogr. 2008 Jan;21(1):53-7. doi: 10.1016/j.echo.2007.05.025. Epub 2007 Jul 12.

DOI:10.1016/j.echo.2007.05.025

PMID:17628422

Abstract

BACKGROUND

This study sought to document the safety of a new accelerated dobutamine-atropine stress echocardiography protocol and to analyze its complications.

METHODS

Dobutamine-atropine stress echocardiography studies were performed using an incremental dobutamine infusion protocol from 20 to 40 microg/kg/min in 3-minute stages and followed by atropine.

RESULTS

A total of 962 patients were included. Mean age was 64 +/- 11 years and 584 were male (61%). Mean ejection fraction was 62 +/- 10%. Complications included hypertensive responses in 66 patients (7%), arrhythmias in 26 (2.7%), and symptomatic hypotension in 16 (1.7%). No patient developed heart failure, acute myocardial infarction, ventricular fibrillation, or died. The independent predictors of hypertensive responses were age, baseline systolic blood pressure, and treatment with nitrates. The independent predictors of arrhythmias were history of hypertension, previous coronary artery disease, and baseline heart rate.

CONCLUSIONS

This accelerated dobutamine-atropine stress echocardiography protocol is safe in a low-risk population and has a rate of complications similar to that reported for the standard protocol.

摘要

背景

本研究旨在记录一种新的加速多巴酚丁胺 - 阿托品负荷超声心动图方案的安全性并分析其并发症。

方法

多巴酚丁胺 - 阿托品负荷超声心动图研究采用递增多巴酚丁胺输注方案，从20至40微克/千克/分钟，每3分钟递增一次，随后给予阿托品。

结果

共纳入962例患者。平均年龄为64±11岁，男性584例（61%）。平均射血分数为62±10%。并发症包括66例患者出现高血压反应（7%），26例出现心律失常（2.7%），16例出现症状性低血压（1.7%）。无患者发生心力衰竭、急性心肌梗死、心室颤动或死亡。高血压反应的独立预测因素为年龄、基线收缩压和硝酸盐治疗。心律失常的独立预测因素为高血压病史、既往冠状动脉疾病和基线心率。