The physiologic basis of dobutamine as compared with dipyridamole stress interventions in the assessment of critical coronary stenosis.
The physiologic basis of dobutamine as compared with dipyridamole stress interventions in the assessment of critical coronary stenosis.
复制标题
多巴酚丁胺与双嘧达莫应激干预在严重冠状动脉狭窄评估中的生理学基础。
DOI：
10.1161/01.cir.76.4.943
复制
发表时间：
1987
期刊：
影响因子：
37.8
通讯作者：
Buda,AJ
中科院分区：
文献类型：
--
作者：
Fung,AY;Gallagher,KP;Buda,AJ
Noninvasive cardiac imaging with echocardiography or thallium-201 scintigraphy utilizing pharmacologic agents as alternatives to exercise is gaining popularity. We investigated the physiologic rationale underlying the optimal choice of pharmacologic stress for functional versus perfusion imaging. With the use of an open-chest dog model, a critical stenosis of the left circumflex coronary artery was produced with total ablation of hyperemic response to a 15 sec period of complete occlusion. Regional left ventricular wall thickening was assessed by quantitative two-dimensional echocardiography. Regional myocardial blood flow was determined by microspheres in both the flow-restricted left circumflex area and the control area supplied by the left anterior descending artery. Eight dogs received 15 micrograms/kg/min dobutamine intravenously for 10 min, and nine dogs received 0.14 mg/kg/min dipyridamole intravenously for 4 min. Dobutamine induced wall thickening abnormalities in all dogs while dipyridamole induced dysfunction in only 55% of the animals studied (p less than .01). Subendocardial blood flow to the left circumflex area was unchanged after both dobutamine and dipyridamole when compared with baseline blood flow. However, subendocardial blood flow increased markedly after dipyridamole in the control area. Regional subendocardial blood flow ratio (left anterior descending/left circumflex) was 3.74 +/- 0.09 (mean +/- SEM) after dipyridamole versus 1.27 +/- 0.09 after dobutamine (p less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)
