No abstract available.
Dobutamine* ; Echocardiography, Stress* ; Myocardium*

No abstract available.
Adenosine* ; Dipyridamole* ; Dobutamine* ; Exercise Test*

No abstract available.
Dobutamine ; Echocardiography, Stress ; Liver Transplantation ; Liver

No abstract available.
Coronary Stenosis* ; Coronary Vessels* ; Dobutamine* ; Echocardiography, Stress* ; Female ; Humans

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Dobutamine* ; Echocardiography, Stress*

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography, Stress* ; Humans ; Myocardium* ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: The 3 minutes increment of dobutamine dose protocol is most commonly used method in dobutamine stress echocardiography (DSE). But the precise hemodynamic response to dobutamine dosage and its difference by extending stage duration have not been well elucidated. MATERIALS AND METHOD: Nineteen healthy voluntary subjects with a mean age of 23.9+/-4.7 years were included. All subjects underwent 3-minutes incremental and 5-minnutes incremental protocol of DSE at random order in a same day. Heart rate, blood pressure, stroke volume, fractional shortening, rate-pressure product and cardiac output were measured every 3 minutes in 3-min protocol of DSE. In 5-min protocol, same variables were measured at 3 minutes of each stage as well as at 5 minutes. RESULTS: 1) Heart rate did not increase until 10 microgram/kg/min dose and increased thereafter by increment of dobutamine dose. 2) Fractional shortening and stroke volume increased markedly from the 5 microgram/kg/min until 20 microgram/kg/min dose and showed slow increase or plateau at a higher dobutamine dose. 3) Systolic blood pressure, cardiac output and rate-pressure product increased continuously from initial dose to maximal dose. 4) Although by extending stage duration to 5 minute in 5-min protocol produced greater hemodynamic effects than those measured at 3 minutes of each stage, there were no significant difference in the results of 3-min and 5-min protocol of DSE. CONCLUSION: The increase of cardiac contractility most contributed to increase of cardiac output until 20microgram/kg/min dose and the increase of herat rate contributed dominantly thereafter, thus the hemodynamic variables showed different responses to increment of dobutamine dose. There were no significant difference in hemodynamic effects between the two protocols. So it is considered that 3-min protocol of DSE gives similar hemodynamic information as 5-min protocol and is more time-saving method.
Blood Pressure ; Cardiac Output ; Dobutamine* ; Echocardiography, Stress* ; Heart Rate ; Hemodynamics* ; Stroke Volume

We studied to investigate the predictive values of gated SPECT for the improvement of wall motion after bypass surgery. As we compared postoperative SPECT with preoperative ones, we defined viability as wall motion improvement. We performed rest 71-201/stress Tc-99m-MIBI gated SPECT in 25 patients before and 3 months after bypass surgery. Myocardial wall motion was graded as normal, hypokinesia, akinesia, and dyskinesia by pair-wise visual analysis of gated pre and postoperative SPECT's on the same monitor screen. Myocardial wall thickening was determined good or poor Among 92 segments with wall motion abnormalities before operation, 69 (75%) improved and 23 did not. Before operation, we could find segments with good systolic thickening in 64 segments among total 92. Thickening of the remaining 28 was poor. Wall motion improved postoperatively in 45 segments (70%) among 64 with good thickening. Twenty four(86%) among 28 segments with poor thickening had also improved. We grouped segments into mild(hypokinetic) and severe(akinetic/dyskinetic) ones. Among 33 segments with severe motion abnormalities, 14 had good thickening and 19 did not. Nine(60%) improved out of 14 segments having severe abnormality with good thickening. However, 16(84%) segments out of 19 having severe abnormality with poor thickening also improved. Neither degree of perfusion decrease nor severity of wall motion abnormalities could explain the high rate of false negatives. In conclusion, as we defined viability as wall motion improvement by comparing pre and postoperative SPECT, systolic thickening observed by gated Tc-99m-MIBI SPECT in myocardial segments with wall motion abnormalities predicted wall motion improvement after bypass surgery. However, poor thickening could not be referred as evidence of nonviable myocardium both in mild and severe contractile dysfunction, so that we might need stimulation study such as dobutamine echocardiography or dobutamine gated SPECT.
Dobutamine ; Dyskinesias ; Echocardiography ; Humans ; Hypokinesia ; Myocardium ; Perfusion ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Dobutamine echocardiography is a useful method to detect myocardial viability in ischemic heart disease. Recently myocardial contrast echocardiography(MCE) is reported to be a new method to evaluate myocardial viability by assessing microvascular integrity of dysfunctional myocardium. We hypothesized if the microvascular integrity is maintained, the dysfunctional myocardium would improve its function by dobutamine infusion. METHOD: 10 myocardial infarction patients (acute : old=8 : 2, M : F=7 : 3, mean age=61+/-11yr) were included in the study. 2 dimensional echocardiography was performed before and during dobutamine infusion and after contrast injection to right and left coronary arteries in the catheterization laboratory. Echocardiographic analysis was done in parasternal short, apical 4 and 2 chamber views. Left ventricule was devided by 20 segments from 3 views. In each segment, will motion score(graded 1, normal, to 5, dyskinesia) before and after dobutamine infusion and opacification grade(0, 0.5, 1 denoting no, intermediate and normal opacification respectively) was compared. RESULTS: The number of segments with abnormal wall motion at baseline were 57 segments. 5 segments was exciuded due to poor image quality. Among 52 segments, 25 segments improved it's function during dobutamine infusion. Improvement of regional function was more frequent in hypokinetic segments than akinetic or dyskinetic segments (69% vs 15%). The improvement of dysfunctional regional wall motion by dobutamine infusion was observed in 80%(19/24), 67%(6/9) and 5%(1/19) of normally, intermediately and none opacified segment respectively. The correlation between wall motion score with opacification grade was 0.598 at baseline and increased to 0.766 after dobutamine infusion. CONCLUSION: In patients with myocardial infarction the dysfunctional segments but intact microvasculature assessed myocardial contrast echocardiography improves function by dobutamine infusion. These findings myocardial contrast echocardiography would be a useful method to detect myocardial viability.
Catheterization ; Catheters ; Coronary Vessels ; Dobutamine* ; Echocardiography* ; Humans ; Microvessels ; Myocardial Infarction* ; Myocardial Ischemia ; Myocardium

BACKGROUND AND OBJECTIVES: Doppler myocardial imaging (DMI) has been suggested as a method of quantifying inducible ischemia during dobutamine stress echocardiography (DSE). Post-systolic motion (PSM) detected by DMI is related to peri-infarct ischemia during DSE. We hypothesized that PSM during DSE would predict recovery of dysfunctional myocardium after successful percutaneous coronary intervention (PCI). SUBJECTS AND METHODS: Thirty patients with dysfunctional myocardium in the left anterior descending coronary artery (LAD) territory were divided into two groups according to improvement of wall motion score index (WMSI) in the LAD territory at 6 months after successful PCI of the LAD. DMI was evaluated in the LAD territory during DSE. Fifteen patients showed improved WMSI (1.42+/-0.39) while the other 15 had unchanged WMSI (1.75+/-0.46) 1 month after PCI. Myocardial velocity was measured in the mid-septal, apico-septal, and basal anterior segments of the LAD artery territory. PSM was defined as a positive wave appearing after the curve of systolic ejection had reached the zero line. RESULTS: Although there was no difference between resting PSMs in both groups, PSM during DSE was significantly higher in the improved WMSI group than in the WMSI group where it was unchanged. CONCLUSION: PSM during DSE predicts recovery of dysfunctional myocardium after successful PCI.
Arteries ; Coronary Vessels ; Dobutamine ; Echocardiography, Stress ; Humans ; Ischemia ; Myocardial Stunning ; Myocardium ; Percutaneous Coronary Intervention