Usefulness of Isometric Exercise During Dobutamine Administration for Stress Echocardiography

Chauvel, Christophe; Bogino, E.; Reynaud, Pascal; Fischer, Bruno; Montserrat, P; Sourdille, Nicolas; Dehant, P.

doi:10.1016/s0002-9149(97)00875-8

Cited by 10 publications

(3 citation statements)

References 6 publications

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“…(2) Patients with an "odd" numerical birthdates did not perform handgrip exercise. Because handgrip was stopped prior to peak imaging, this study was not designed to evaluate whether handgrip increased test sensitivity or detection of ischemia; 11,12 rather it was designed to evaluate whether handgrip would decrease test duration and dosage of dobutamine and atropine administered. In both groups, intravenous atropine was administered in four divided doses of 0.5 mg to a maximum of 2 mg after the 40 µg/kg/min dose infusion stage only if target heart rate (85% of age-predicted heart rate) was not achieved.…”

Section: Dobutamine Stress Echocardiography and Handgrip Exercisementioning

confidence: 99%

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Isometric handgrip exercise during dobutamine‐atropine stress echocardiography increases heart rate acceleration and decreases study duration and dobutamine and atropine dosage

Yao

Moldenhauer

Sherrid

2003

Clinical Cardiology

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SummaryBackground: Dobutamine-atropine stress echocardiography (DASE) is an established test for the diagnosis and risk stratification of patients with coronary artery disease. Atropine use to attain target heart rate prolongs test time.Hypothesis: The aim of this study was to assess the utility of isometric handgrip exercise (33% maximal voluntary contraction ϫ 4 min) with DASE.Methods: We prospectively evaluated 131 patients undergoing DASE randomized to handgrip exercise or no handgrip. Effect of handgrip exercise on endpoints: time to target heart rate (85% maximum predicted), recovery time, total test time, mean dobutamine and atropine dosage, and the number of ischemic responses were assessed. Effect of current beta-blocker medication use was also evaluated.Results: Heart rate rose more quickly in the handgrip group. At 6-10 min (peak handgrip), mean heart rate rose 51 ± 14 beats/min in the handgrip group compared with 38 ± 18 beats/min in the no handgrip group (p < 0.0001). With handgrip, overall dobutamine study time was reduced by a mean of 4.3 min (16.4 ± 6.9 vs. 20.7 ± 8.4, p = 0.004) in all patients, and by a mean of 5.9 min in patients not on beta-blocker medication (p = 0.001). The handgrip group also had a lower mean dose of dobutamine (25.8 ± 13.5 vs. 32.4 ± 16.4 mg, p = 0.025). The mean atropine dose was also lower (0.2 ± 0.4 vs.

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Section: Dobutamine Stress Echocardiography and Handgrip Exercisementioning

confidence: 99%

“…Chauvel et al previously reported on a cohort of 99 patients undergoing DASE. 11 Handgrip exercise was administered during echocardiographic imaging in this study, different from our protocol. Addition of handgrip improved test sensitivity compared with dobutamine alone.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

Isometric handgrip exercise during dobutamine‐atropine stress echocardiography increases heart rate acceleration and decreases study duration and dobutamine and atropine dosage

Yao

Moldenhauer

Sherrid

2003

Clinical Cardiology

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“…Dobutamine stress echocardiography (DSE) is commonly used to assess the extent, location, and severity of coronary artery disease (CAD) and myocardial viability [ 1 - 6 ]. The duration and infusion dose of dobutamine for the assessment of myocardial ischemia and viability has been studied extensively [ 7 - 10 ]. Currently, in patients with suspected or known CAD, most laboratories use stepwise increments of dobutamine at 3-minute intervals, which has evolved from the commonly used exercise treadmill protocols.…”

Section: Introductionmentioning

confidence: 99%

Feasibility, safety and tolerability of accelerated dobutamine stress echocardiography

Minardi

Manzara

Pulignano

et al. 2007

Cardiovasc Ultrasound

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A continuous infusion of a single high dose of dobutamine has been, recently, suggested as a simple and effective protocol of stress echocardiography. The present study assesses the feasibility, safety, and tolerability of an accelerated dobutamine stress protocol performed in patients with suspected or known coronary artery disease. Two hundred sixty five consecutive patients underwent accelerated dobutamine stress echocardiography: the dobutamine was administered at a constant dose of 50 μg/kg/min for up to 10 minutes. The mean weight-adjusted cumulative dose of dobutamine used was 330 ± 105.24 μg/kg. Total duration of dobutamine infusion was 6.6 ± 2.1 min. Heart rate rose from 69.9 ± 12.1 to 123.1 ± 22.1 beats/min at peak with a concomitant change in systolic blood pressure (127.6 ± 18.1 vs. 167.6 ± 45.0 mmHg). Dobutamine administration produced a rapid increase in heart rate (9.4 ± 5.9 beats/min2). The side effects were similar to those described with the standard protocol; the most common were frequent premature ventricular complexes (21.5%), frequent premature atrial complexes (1.5%) and non sustained ventricular tachycardia (1.5%); among non cardiac symptoms the most frequent were nausea (3.4%), headache (1.1%) and symptomatic hypotension (1.1%). No major side effects were observed during the test. Our data demonstrate that a continous infusion of a single high dose of dobutamine is a safe and well tolerated method of performing stress echocardiography in patients with suspected or known coronary artery disease. This new protocol requires the administration of lower cumulative dobutamine dose than standard protocol and results in a significant reduction in test time.

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Hyperventilation, Handgrip, Cold Pressor Stress Echocardiography

Djordjevic-Dikic,

Picano

2023

Stress Echocardiography

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Usefulness of Isometric Exercise During Dobutamine Administration for Stress Echocardiography

Cited by 10 publications

References 6 publications

Isometric handgrip exercise during dobutamine‐atropine stress echocardiography increases heart rate acceleration and decreases study duration and dobutamine and atropine dosage

Isometric handgrip exercise during dobutamine‐atropine stress echocardiography increases heart rate acceleration and decreases study duration and dobutamine and atropine dosage

Feasibility, safety and tolerability of accelerated dobutamine stress echocardiography

Hyperventilation, Handgrip, Cold Pressor Stress Echocardiography

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