Key result
Dobutamine stress echocardiography significantly increased systolic right ventricular peak from 8.0 to 13.7 (p<0.001) and decreased right ventricular cardiac output in 54% of patients with 3-vessel CAD.
Why the study?
Does dobutamine stress echocardiography detect ischemic right ventricular dysfunction in patients with three-vessel CAD?
Cross-Sectional (n=13)
No
Does dobutamine stress echocardiography detect ischemic right ventricular dysfunction in patients with three-vessel CAD?
Dobutamine stress echocardiography can identify ischemic right ventricular dysfunction in patients with three-vessel CAD, as evidenced by decreased RV cardiac output and changes in TAPS.
DSE may identify RV dysfunction in three-vessel CAD; leaves open its prognostic role and clinical adoption pending prospective studies.
BACKGROUND: Dobutamine stress echocardiography (DSE) is a non-invasive technique to detect coronary artery diseases (CAD). There are limited studies on evaluation of the right ventricular function by stress echocardiography. The appropriate evaluation of RV function and early diagnosis of its failure can help to improve outcomes for the patients undergoing cardiac surgery. OBJECTIVE: To determine right ventricular dysfunction in patients with three-vessel CAD by using DSE. METHODS: This cross-sectional study was among 13 patients who were candidates for coronary artery bypass grafting (CABG) referred to Ghaem Hospital, Mashhad, Iran; from September 2015 to May 2016. After a physical examination and initial measures, DSE was performed and echocardiographic parameters were recorded by a cardiologist. Paired-samples t-test was performed using SPSS Software v.16.0 for data analysis. RESULTS: The study included 13 patients (9 males) with a mean age of 65.4±7.6 years. The mean of TAPS was 16.9±4.5 mm and 15.7±2.9 mm before and after stress echocardiography, respectively (p=0.69). Systolic right ventricular (SRV) peak increased from before DSE compared with after DSE (8.0±2.2 vs. 13.7±4.2 mm/s, p<0.001). In addition, after dobutamine injection, right ventricular (RV) cardiac output decreased in 7 patients and one patient was affected by post-ejection shortening. CONCLUSION: It seems that TAPS and RV cardiac output after injection of dobutamine, can be used as markers for the recognition of ischemic RV dysfunction.
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Bagheri et al. (2018) conducted a cross-sectional in Three-vessel coronary artery disease (n=13). Dobutamine stress echocardiography vs. Baseline (before dobutamine injection) was evaluated on Systolic right ventricular (SRV) peak (p=<0.001). Dobutamine stress echocardiography significantly increased systolic right ventricular peak from 8.0 to 13.7 (p<0.001) and decreased right ventricular cardiac output in 54% of patients with 3-vessel CAD.
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