Intraventrikuläre Obstruktionen bei der Dobutamin-Streßechokardiographie: Determinanten ihrer Entstehung und klinische Folgen (Dynamic intraventricular obstruction during dobutamine stress echocardiography. Determinants of the phenomenon and clinical consequences)

Wagner, Ştefan; Mohr-Kahaly, Susanne; Nixdorff, Uwe; Kuntz, S.; Menzel, Thomas; Kölsch, B.; Meinert, Rolf; Meyer, Jürgen

doi:10.1007/s003920050065

Cited by 5 publications

(2 citation statements)

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“…Therefore, the development of a mild to moderate intraventricular gradient during dobutamine stress is frequent and may have no major clinical significance in the majority of patients with LVBS as in the general population. The significant association found in our patients between dynamic intraventricular gradient and septal hypertrophy is in keeping with the studies by Khanal et al [21] and Wagner et al [9], who showed that dobutamine-induced LV cavity obliteration was associated with female sex and LV hypertrophy. Thus, the dynamic intraventricular obstruction documented in our patients does not seem to be a specific feature of LVBS, but rather depends upon the presence of a localized septal hypertrophy that is frequently found in elderly women.…”

Section: Discussionsupporting

confidence: 93%

“…These findings and the association of dobutamine-induced dynamic intraventricular gradient with worsening of apical wall motion recently reported in 2 patients with LVBS and septal hypertrophy [7] suggested a possible pathogenetic role for dynamic intraventricular obstruction in LVBS. The prevalence of dobutamine-induced dynamic obstruction in our patients with LVBS is similar to that reported by previous studies in patients undergoing dobutamine stress echocardiography for evaluation of coronary artery disease [8-11,20-22], that showed a prevalence ranging from 13% in the study by Heinle et al [10] to 53% by Wagner et al [9]. Therefore, the development of a mild to moderate intraventricular gradient during dobutamine stress is frequent and may have no major clinical significance in the majority of patients with LVBS as in the general population.…”

Section: Discussionsupporting

confidence: 90%

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Dobutamine stress echocardiography for assessing the role of dynamic intraventricular obstruction in left ventricular ballooning syndrome

Previtali

Camporotondo

Repetto

et al. 2010

Cardiovasc Ultrasound

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BackgroundDynamic intraventricular obstruction has been observed in patients with left ventricular ballooning syndrome (LVBS) and has been hypothesized as a possible mechanism of the syndrome. The aim of this study was to assess the prevalence and significance of dynamic intraventricular obstruction in patients with LVBS.Methods and ResultsDobutamine stress echocardiography was carried out in 22 patients with LVBS (82% apical), all women, aged 68 ± 9 years. At baseline 1 patient had a > 30 mmHg LV gradient; during stress a LV gradient > 30 mm Hg developed in 6/21 patients (28%) and was caused by systolic anterior motion of the mitral valve in the 3 patients with severe gradient (mean 116 ± 29 mmHg), who developed mitral regurgitation and impaired apical wall motion and by obstruction at mid-ventricular level in the other 3 with a moderate gradient (mean 46 ± 16 mmHg). Compared with patients without obstruction those with obstruction had a greater mean septal thickness (11.6 ± .6 vs 9.8. ± 3, p < .01), a higher prevalence of septal hypertrophy (71% vs 7%, p < .005) and a higher peak wall motion score index (1.62 ± .4 vs 1.08 ± .4, p < .01).ConclusionSpontaneous or dobutamine-induced dynamic LV obstruction is documented in 32% of patients with LVBS, is correlated with the presence of septal hypertrophy and may play a role in the development of LVBS in this subset of patients. In those without septal hypertrophy a dynamic obstruction is rarely induced with dobutamine and is unlikely to be a major pathogenetic factor of the syndrome.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

Dobutamine stress echocardiography for assessing the role of dynamic intraventricular obstruction in left ventricular ballooning syndrome

Previtali

Camporotondo

Repetto

et al. 2010

Cardiovasc Ultrasound

View full text Add to dashboard Cite

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Long-Term Follow-Up of Atrioventricular Septal Defect

Lunde¹,

Broberg²

2010

Cases in Adult Congenital Heart Disease

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Are intraventricular gradients a cause of false positive treadmill exercise tests?

Cardim

Campos

Ferreira

et al. 2012

Revista Portuguesa de Cardiologia

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1. The prevalence of IVG during dobutamine stress echocardiography in a selected population of false positives on treadmill stress testing is very high, occurring in more than two-thirds of patients. 2. This prevalence is significantly higher than that described for non-selected populations. 3. Age, gender, risk factors for CAD, treatment with beta-blockers/calcium channel antagonists, significant valvular disesase/LVH, symptoms and blood pressure during stress were not associated with the presence or absence of IVG. 4. The presence of IVG is associated with the occurrence of ischemic ST changes during dobutamine stress echocardiography.

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Intraventrikuläre Obstruktionen bei der Dobutamin-Streßechokardiographie: Determinanten ihrer Entstehung und klinische Folgen (Dynamic intraventricular obstruction during dobutamine stress echocardiography. Determinants of the phenomenon and clinical consequences)

Abstract: Intraventricular obstructions during DSE are often observed in pts with normal systolic function at rest and during peak stress, especially in the case of left ventricular hypertrophy. (ABSTRACT TRU

Cited by 5 publications

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Dobutamine stress echocardiography for assessing the role of dynamic intraventricular obstruction in left ventricular ballooning syndrome

Dobutamine stress echocardiography for assessing the role of dynamic intraventricular obstruction in left ventricular ballooning syndrome

Long-Term Follow-Up of Atrioventricular Septal Defect

Are intraventricular gradients a cause of false positive treadmill exercise tests?

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