Comparison of dobutamine stress echocardiography and exercise echocardiography in evaluating left ventricular outflow tract obstruction in patients with hypertrophic cardiomyopathy
10.3760/cma.j.issn.0253-3758.2012.03.008
- VernacularTitle:多巴酚丁胺激发超声与运动负荷超声评估肥厚型心肌病左心室流出道压力阶差的对照研究
- Author:
Chun-Li SHAO
1
;
Fu-Jian DUAN
;
Shu-Bin QIAO
;
Shi-Jie YOU
;
Feng-Huan HU
;
Jian-Song YUAN
;
Wei-Xian YANG
Author Information
1. 中国医学科学院北京协和医学院阜外心血管病医院
- Keywords:
Cardiomyopathy,hypertrophic;
Echocardiography
- From:
Chinese Journal of Cardiology
2012;40(3):214-218
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare left ventricular outflow tract (LVOT) gradient induced by dobutamine stress echocardiography (DSE) and exercise echocardiography (EE) in patients with hypertrophic cardiomyopathy (HCM).Methods DSE and EE were performed in 40 consecutive patients with HCM and LVOT gradient ＜50 mm Hg( 1mm Hg =0.133 kPa) at rest.Dobutamine was administered intravenously at incremental doses of 200,400,600,800 and 1200 p.g/min at 5 min intervals. LVOT gradients were measured at rest,at peak exercise and during each dose of DSE.Results LVOT gradient at rest was lower than 30 mm Hg in 36 patients and between 30 and 49 mm Hg in 4 patients.Of the 36 patients with LVOT gradient ＜ 30 mm Hg at rest,mechanical LVOT obstruction (latent LVOTO)was evidenced in 17 patients during EE and in 18 patients during DSE and good consistency (91.7％,kappa value 0.833) was found between the two maneuvers.The provoked gradient was similar between DSE at 800 μg/min and EE at peak exercise( P =0.181 ).In the 4 patients with LVOT gradient between 30 and 49 mm Hg[ (38.8 + 2.6)mm Hg],LVOT gradient increased to (85.3 +26.4) mm Hg during EE and (105.0 ±28.0) mm Hg during DES.Conclusions DES and EE are comparable and suitable provoke methods for identifying LVOT obstruction in patients with HCM.
