MethodsQuantification of the Myocardial Response to Low-Dose Dobutamine Using Tissue Doppler Echocardiographic Measures of Velocity and Velocity Gradient
Section snippets
Methods
Twelve normal volunteers (10 men and 2 women, age 34 ± 5 years), with no history of cardiovascular disease and normal routine 2-dimensional and Doppler echocardiograms were selected for study. The protocol was approved by the Institutional Review Board for Biomedical Research and all subjects gave written informed consent. Echocardiographic data were acquired with a 3.75-MHz, phased-array transducer and a TD ultrasound system (SSA-380A, Toshiba Corp., Tochigi, Japan) described elsewhere in
Endocardial Time-Velocity Plots:
Examples of endocardial time-velocity plots at each stage of dobutamine appear in Fig. 4, with group mean results of peak systolic velocity shown in Fig. 5. Significant increases from baseline in peak systolic endocardial velocity occurred with 2 μg/kg/min of dobutamine infusion in both anteroseptum and posterior walls. Further highly significant increases occurred with 5 μg/kg/min compared with all previous stages, demonstrating a dose-response relation (p <0.0001 vs 3 μg/kg/min dose).
Discussion
This study demonstrates that measures of myocardial velocity and velocity gradient using color-coded TD echocardiography can be applied to assess noninvasively alterations in LV function induced by pharmacologic inotropic modulation. Significant changes in TD indexes of global and regional function were consistently detected with infusions of very low doses of dobutamine in normal subjects. Alterations in mitral annular velocity were detected with a dose of only 1 μg/kg/min, and endocardial
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