Radionuclide assessment of left ventricular function during dobutamine infusion in patients with coronary artery disease: Comparison with ergometer exercise

The effects of dobutamine on left ventricular function were assessed employing radionuclide ventriculography (RNV) in 7 normal subjects (Group 1) and 21 patients with coronary artery disease (Group 2). After routine bicycle ergometer exercise RNV, dobutamine infusion was started at 5 micrograms/kg/min and the dosage was increased by 5 micrograms/kg/min every 4 minutes to a total of 15 micrograms/kg/min. In Group 1, left ventricular ejection fraction (LVEF) increased by both ergometer exercise and dobutamine infusion. In Group 2, LVEF did not increase during exercise, but increased during dobutamine infusion without evidence of significant myocardial ischemia. Only 2 patients in Group 2 had new regional wall motion abnormality. Left ventricular end-diastolic volume (LVEDV) in Group 2 increased from 191 +/- 19 to 210 +/- 18 ml during ergometer exercise, but decreased from 193 +/- 18 to 153 +/- 19 ml during dobutamine infusion. Short-term low-dose infusion of dobutamine may be used in patients without evidence of significant myocardial ischemia, but probably cannot be substituted for exercise testing in patients with mild to moderate coronary artery disease.