The functional significance of chronotropic incompetence during dobutamine stress test
Key result
Chronotropic incompetence during dobutamine stress echo shows no link to increased ischaemia prevalence.
- n=512
Why the study?
Does chronotropic incompetence during dobutamine stress echocardiography indicate a higher prevalence of ischaemia or significant coronary artery disease in patients not on beta blockers?
Population
512 patients without beta blocker treatment who underwent dobutamine stress echocardiography and completed…
Comparison
Chronotropic incompetence during dobutamine… vs Normal chronotropic response during dobutamine…
Design
Cross-sectional
Authors
Discussion
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Implication
Chronotropic incompetence during dobutamine stress echo was not linked to ischaemia; leaves open whether age- and sex-specific targets are needed.
Study Design
Type
Observational (n=512)
Structured PICO
Does chronotropic incompetence during dobutamine stress echocardiography indicate a higher prevalence of ischaemia or significant coronary artery disease in patients not on beta blockers?
P
Population
512 patients without beta blocker treatment who underwent dobutamine stress echocardiography to evaluate the functional significance of chronotropic incompetence.
E
Exposure
Chronotropic incompetence (failure to achieve 85% of the maximum exercise heart rate predicted for age and sex) during dobutamine stress echocardiography (up to 40 microg/kg/min)
C
Comparator
Normal chronotropic response during dobutamine stress echocardiography
O
Outcome
Prevalence of ischaemia and significant coronary artery disease, and predictors of chronotropic incompetencesurrogate
Chronotropic incompetence during dobutamine stress echocardiography does not indicate increased ischaemia or coronary artery disease, suggesting that dobutamine-specific heart rate targets based on age and sex should be used rather than exercise-derived targets.
Cite This Study
Elhendy et al. (1999) conducted an observational in Patients undergoing dobutamine stress echocardiography (n=512). Chronotropic incompetence vs. No chronotropic incompetence was evaluated on Overall prevalence of ischaemia and significant coronary artery disease. Chronotropic incompetence occurred in 38% of patients and was independently predicted by lower resting heart rate, younger age, and male sex (all p<<0.001), with no difference in ischaemia prevalence.