Intracoronary versus intravenous dobutamine stress echocahdiography

relationships between flow and function

Jeffrey S. Cohen, Alice K. Jacobs, Thomas Noonan, Lijie Ma, Linda Gillam, Chunguang Cben, Ravin Davidoff

Research output: Contribution to journalArticle

Abstract

We have shown in humans that intracoronary(IC) dobutamine(D) infusions proximal to stenoses elicit echocardiographic (Echo) manifestations of ischemia. To assess the mechanism of regional ischemia vith IC D, 9 hyperemic flow limiting LAD steroses wie created in 5 open-chest pigs and compared with intravenous (IV) D. Echo, LAD flow(CBF), heart rate (HR) and aortic pressures (MAP) vere reconlda during subselective infusions of IC D (2.5-50μg/min and during IV D (5-30 μg/kg/min). Echos vere analyzed by the centerline method for LAD wall thickening (WT). Aortic and coronary venous blood sampling vas done for regional myocardial oxygen consumption (MVO2) calculations. (n=4). Resido:(Tablt) IC and IV D induce a similar biphasic responses in LAD WT but with different effects upon HR and MAP. The absolute CBF differs between IC and IV D, suggesting induction of ischemia via different mechanisms. Hovever, vhen normalized for HR and MAP, the CBF is similar. IC and IV MVO2 was the same for 2/4 stenoses Mode HR MAP WT CBF CBF/HR CBF/HR/MAP Base 115 ± 10 65 ± 9 27 ± 8 1.0 ± 0.2 8 ± 2 13 ± 3 IC-LD 122 ± 9 68 ± 11 38 ± 6 1.1 ± 0.2 9 ± 2 14 ± 5 IV-LD 142 ± 10*81 ± 18*41 ± 7 1.8 ± 0.8*13 ± 6 16 ± 6 IC-P 133 ± 18 66 ± 10 17 ± 7 1.2 ± 0.3 9 ± 1 14 ± 3 IV-P 179 ± 19*78 ± 16*15 ± 6 1.7 ± 0.7*10 ± 4 13 ± 4*p≤0.01 compared to IC; Base=baseline, LD=low dose, P=peak dose. Conclusions: IC dobutamine echocardiography induces changes in WT similar to IV dobtrtamine under different hemodyaamic conditions. Despite these differences, the regional flow - function relationship is indisting uishable between the two methods. This further supports the clinical utility of IC dobutamine echocardiogiaphy as a functional assessment of a coronary stenosis.

Original languageEnglish (US)
Number of pages1
JournalJournal of the American Society of Echocardiography
Volume10
Issue number4
StatePublished - Dec 1 1997
Externally publishedYes

Fingerprint

Dobutamine
Heart Rate
Ischemia
Pathologic Constriction
Coronary Stenosis
Oxygen Consumption
Echocardiography
Arterial Pressure
Swine
Thorax

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Cohen, Jeffrey S. ; Jacobs, Alice K. ; Noonan, Thomas ; Ma, Lijie ; Gillam, Linda ; Cben, Chunguang ; Davidoff, Ravin. / Intracoronary versus intravenous dobutamine stress echocahdiography : relationships between flow and function. In: Journal of the American Society of Echocardiography. 1997 ; Vol. 10, No. 4.
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title = "Intracoronary versus intravenous dobutamine stress echocahdiography: relationships between flow and function",
abstract = "We have shown in humans that intracoronary(IC) dobutamine(D) infusions proximal to stenoses elicit echocardiographic (Echo) manifestations of ischemia. To assess the mechanism of regional ischemia vith IC D, 9 hyperemic flow limiting LAD steroses wie created in 5 open-chest pigs and compared with intravenous (IV) D. Echo, LAD flow(CBF), heart rate (HR) and aortic pressures (MAP) vere reconlda during subselective infusions of IC D (2.5-50μg/min and during IV D (5-30 μg/kg/min). Echos vere analyzed by the centerline method for LAD wall thickening (WT). Aortic and coronary venous blood sampling vas done for regional myocardial oxygen consumption (MVO2) calculations. (n=4). Resido:(Tablt) IC and IV D induce a similar biphasic responses in LAD WT but with different effects upon HR and MAP. The absolute CBF differs between IC and IV D, suggesting induction of ischemia via different mechanisms. Hovever, vhen normalized for HR and MAP, the CBF is similar. IC and IV MVO2 was the same for 2/4 stenoses Mode HR MAP WT CBF CBF/HR CBF/HR/MAP Base 115 ± 10 65 ± 9 27 ± 8 1.0 ± 0.2 8 ± 2 13 ± 3 IC-LD 122 ± 9 68 ± 11 38 ± 6 1.1 ± 0.2 9 ± 2 14 ± 5 IV-LD 142 ± 10*81 ± 18*41 ± 7 1.8 ± 0.8*13 ± 6 16 ± 6 IC-P 133 ± 18 66 ± 10 17 ± 7 1.2 ± 0.3 9 ± 1 14 ± 3 IV-P 179 ± 19*78 ± 16*15 ± 6 1.7 ± 0.7*10 ± 4 13 ± 4*p≤0.01 compared to IC; Base=baseline, LD=low dose, P=peak dose. Conclusions: IC dobutamine echocardiography induces changes in WT similar to IV dobtrtamine under different hemodyaamic conditions. Despite these differences, the regional flow - function relationship is indisting uishable between the two methods. This further supports the clinical utility of IC dobutamine echocardiogiaphy as a functional assessment of a coronary stenosis.",
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Intracoronary versus intravenous dobutamine stress echocahdiography : relationships between flow and function. / Cohen, Jeffrey S.; Jacobs, Alice K.; Noonan, Thomas; Ma, Lijie; Gillam, Linda; Cben, Chunguang; Davidoff, Ravin.

In: Journal of the American Society of Echocardiography, Vol. 10, No. 4, 01.12.1997.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intracoronary versus intravenous dobutamine stress echocahdiography

T2 - relationships between flow and function

AU - Cohen, Jeffrey S.

AU - Jacobs, Alice K.

AU - Noonan, Thomas

AU - Ma, Lijie

AU - Gillam, Linda

AU - Cben, Chunguang

AU - Davidoff, Ravin

PY - 1997/12/1

Y1 - 1997/12/1

N2 - We have shown in humans that intracoronary(IC) dobutamine(D) infusions proximal to stenoses elicit echocardiographic (Echo) manifestations of ischemia. To assess the mechanism of regional ischemia vith IC D, 9 hyperemic flow limiting LAD steroses wie created in 5 open-chest pigs and compared with intravenous (IV) D. Echo, LAD flow(CBF), heart rate (HR) and aortic pressures (MAP) vere reconlda during subselective infusions of IC D (2.5-50μg/min and during IV D (5-30 μg/kg/min). Echos vere analyzed by the centerline method for LAD wall thickening (WT). Aortic and coronary venous blood sampling vas done for regional myocardial oxygen consumption (MVO2) calculations. (n=4). Resido:(Tablt) IC and IV D induce a similar biphasic responses in LAD WT but with different effects upon HR and MAP. The absolute CBF differs between IC and IV D, suggesting induction of ischemia via different mechanisms. Hovever, vhen normalized for HR and MAP, the CBF is similar. IC and IV MVO2 was the same for 2/4 stenoses Mode HR MAP WT CBF CBF/HR CBF/HR/MAP Base 115 ± 10 65 ± 9 27 ± 8 1.0 ± 0.2 8 ± 2 13 ± 3 IC-LD 122 ± 9 68 ± 11 38 ± 6 1.1 ± 0.2 9 ± 2 14 ± 5 IV-LD 142 ± 10*81 ± 18*41 ± 7 1.8 ± 0.8*13 ± 6 16 ± 6 IC-P 133 ± 18 66 ± 10 17 ± 7 1.2 ± 0.3 9 ± 1 14 ± 3 IV-P 179 ± 19*78 ± 16*15 ± 6 1.7 ± 0.7*10 ± 4 13 ± 4*p≤0.01 compared to IC; Base=baseline, LD=low dose, P=peak dose. Conclusions: IC dobutamine echocardiography induces changes in WT similar to IV dobtrtamine under different hemodyaamic conditions. Despite these differences, the regional flow - function relationship is indisting uishable between the two methods. This further supports the clinical utility of IC dobutamine echocardiogiaphy as a functional assessment of a coronary stenosis.

AB - We have shown in humans that intracoronary(IC) dobutamine(D) infusions proximal to stenoses elicit echocardiographic (Echo) manifestations of ischemia. To assess the mechanism of regional ischemia vith IC D, 9 hyperemic flow limiting LAD steroses wie created in 5 open-chest pigs and compared with intravenous (IV) D. Echo, LAD flow(CBF), heart rate (HR) and aortic pressures (MAP) vere reconlda during subselective infusions of IC D (2.5-50μg/min and during IV D (5-30 μg/kg/min). Echos vere analyzed by the centerline method for LAD wall thickening (WT). Aortic and coronary venous blood sampling vas done for regional myocardial oxygen consumption (MVO2) calculations. (n=4). Resido:(Tablt) IC and IV D induce a similar biphasic responses in LAD WT but with different effects upon HR and MAP. The absolute CBF differs between IC and IV D, suggesting induction of ischemia via different mechanisms. Hovever, vhen normalized for HR and MAP, the CBF is similar. IC and IV MVO2 was the same for 2/4 stenoses Mode HR MAP WT CBF CBF/HR CBF/HR/MAP Base 115 ± 10 65 ± 9 27 ± 8 1.0 ± 0.2 8 ± 2 13 ± 3 IC-LD 122 ± 9 68 ± 11 38 ± 6 1.1 ± 0.2 9 ± 2 14 ± 5 IV-LD 142 ± 10*81 ± 18*41 ± 7 1.8 ± 0.8*13 ± 6 16 ± 6 IC-P 133 ± 18 66 ± 10 17 ± 7 1.2 ± 0.3 9 ± 1 14 ± 3 IV-P 179 ± 19*78 ± 16*15 ± 6 1.7 ± 0.7*10 ± 4 13 ± 4*p≤0.01 compared to IC; Base=baseline, LD=low dose, P=peak dose. Conclusions: IC dobutamine echocardiography induces changes in WT similar to IV dobtrtamine under different hemodyaamic conditions. Despite these differences, the regional flow - function relationship is indisting uishable between the two methods. This further supports the clinical utility of IC dobutamine echocardiogiaphy as a functional assessment of a coronary stenosis.

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