J 2022

Myocardial injury in stress echocardiography: Comparison of dobutamine, dipyridamole and dynamic stressors-single center study

MEDILEK, Karel, Lenka ZALOUDKOVA, Alexander BORG, Lucie KUBÍNOVÁ, Josef STASEK et. al.

Basic information

Original name

Myocardial injury in stress echocardiography: Comparison of dobutamine, dipyridamole and dynamic stressors-single center study

Authors

MEDILEK, Karel (203 Czech Republic, guarantor), Lenka ZALOUDKOVA (203 Czech Republic), Alexander BORG, Lucie KUBÍNOVÁ (203 Czech Republic, belonging to the institution) and Josef STASEK (203 Czech Republic)

Edition

Echocardiography - A Journal of Cardiovascular Ultrasound and Allied Techniques, HOBOKEN, WILEY, 2022, 0742-2822

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 1.500

RIV identification code

RIV/00216224:14110/22:00128278

Organization unit

Faculty of Medicine

DOI

UT WoS

000838624800001

Keywords in English

negative stress echocardiography; myocardial injury; hsTnT

Tags

Tags

International impact, Reviewed
Změněno: 25/1/2023 14:06, Mgr. Tereza Miškechová

Abstract

V originále

Objectives: In stress echocardiography (SE), dipyridamole (DIP) and dynamic stress (ExSE) are reported as being safer than dobutamine stress echocardiography (DSE). We investigated whether these commonly used stressors cause myocardial injury, measured by high sensitivity troponin T (hsTnT). Methods: One hundred and thirty five patients (DSE n = 46, ExsE n = 46, DIP n = 43) with negative result of SE were studied. The exclusion criteria were known ischaemic heart disease (IHD), baseline wall motion abnormalities, left ventricle systolic dysfunction/regional wall motion abnormalities, septum/posterior wall >= 13 mm, diabetes/pre-diabetes, baseline hsTnT level >= 14 ng/L, baseline blood pressure >= 160/100 mmHg, peak pulmonary pressure >= 45mmHg, eGFR <1ml/s/1.73m(2), more than mild to moderate valvular disease and dobutamine side effects. HsTnT was measured before and 180 minutes after the test. Results: All patients had low pre-test probabilities of having obstructive IHD. HsTnT increased in DSE, less so in ExSE, and was unchanged in the DIP group (Delta hsTnT 9.4 [1.5-58.6], 1.1 [-0.9-15.7], -0.1 [-1.4-2.1] ng/L, respectively, p<0.001). In DSE, the Delta hsTnT was associated with peak dobutamine dose (r = 0.30, p = 0.045), test length (r = 0.43, p = 0.003) and atropine use (p<0.001). In ExSE, the hsTnT increase was more likely in females (p = 0.012) and the elderly (>65 years) (r = 0.32, p = 0.03); no association was found between atropine use (p = 0.786) or test length and AhsTnT (r = 0.10, p = 0.530). Conclusions: DSE is associated with myocardial injury in patients with negative SE, no injury was observed in DIP and only mild case in ExSE. Whether myocardial injury is causative of the higher reported adverse event rates in DSE remains to be determined.