Influence of low dobutamine dose on left ventricular diastolic flow parameters in subjects with low ejection fraction.
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Adult↗
Biomedical subjects
Andrzej Wojtarowicz
Publications and source records attributed to Andrzej Wojtarowicz.
[Doppler echocardiographic evaluation of left ventricular diastolic function in patients with hypertrophic obstructive cardiomyopathy after alcohol septal ablation in acute and long-term follow up].
UNLABELLED: Left ventricular (LV) diastolic dysfunction is responsible for most clinical symptoms in hypertrophic cardiomyopathy. The left ventricular outflow tract (LVOT) obstruction has additional negative haemodynamic influence. Alcohol septal ablation reduces the LVOT gradient. CEL The aim of our study was the evaluation of acute and long-term changes of LV diastolic function after successful alcohol septal ablation. MATERIAL AND METHODS: In 15 patients with successful reducing of LVOT gradient the LV diastolic function was assessed using Doppler echocardiography before ablation and in short and long-term follow-up. RESULTS: Before ablation IVRT and DT were prolonged in comparison to normal values. In acute phase after ablation E/A ratio decreased from 1.19 +/- 0.36 to 0.89 +/- 0.27 (p < 0.01), but returned to baseline by the first week. In long-term follow-up there was again a significant reducing of E/A ratio (mainly due to E wave changes). IVRT was significantly shortened from 98 +/- 20 ms at baseline to 80.5 +/- 17 ms at day 7 and later. This change was stable to the end of follow-up. DT did not change significantly just after the ablation and during follow-up. CONCLUSIONS: In the acute period after alcohol septal ablation there is an increase of LV relaxation disorders. Changes observed during long-term follow-up are difficult to interpret, but significant shortening of IVRT shows on improvement of the LV diastolic function.
Adult↗
[Effect of low dobutamine doses dobutamine on left ventricular diastolic flow parameters in subjects with a low ejection fraction].
UNLABELLED: A low dobutamine dose (DOB) improves the systolic function of impaired myocardium. There are some data suggesting the improvement of left ventricular (LV) diastolic function as well. The aim of this work was to assess the influence of DOB on some left ventricular diastolic flow parameters: inflow curve profile and early inflow wave propagation velocity (Prop). MATERIAL AND METHODS: 33 persons (7 women and 26 men) aged 35-74, with a mean age of 53 and with an ejection fraction (EF) < 35% were examined. DOB was administered in doses of 5 and 10 micrograms/kg/min every 3 minutes. At the beginning of the examination (D-0) and at the end (D-1), the LV contractility and the following inflow parameters were assessed: E and A waves velocities, E/A-ratio on mitral orifice level (U) and at the half of LV (1/2 LV) and Prop. RESULTS: DOB increased the heart rate from 69.4/min to 74.4/min (p < 0.01) and improved the LV contractility in every case. We observed no significant changes of the E wave velocity influenced by DOB on U (D-O: 0.7 +/- 0.22 m/s; D-1: 0.68 +/- 0.2 m/s) and in 1/2 LV, or no E/A changes (D-O: 1.24 +/- 0.71; D-1 1.21 +/- 1.08 on U and D-O: 1.68 +/- 1.06; D-1: 1.64 +/- 1.16 in 1/2 LV). Statistically significant differences were recorded only between A in D-O and A in D-1 on both levels (p < 0.05): D-O was 0.66 +/- 0.21 m/s and D-1 was 0.71 +/- 0.22 m/s on U and D-O was 0.422 +/- 0.2 m/s and D-1 was 0.47 +/- 0.2 m/s in 1/2 LV. Significant Prop shortening was ascertained: from 39.4 +/- 10.9 cm/s to 45.4 +/- 16.1 cm/s; p < 0.01. The correlation registered at rest between Prop and EF (R = 0.4) and Prop and contractility index (R = -0.52), was recorded at a similar level after DOB as well. No correlation between Prop and heart rate was seen. CONCLUSIONS: 1. Dobutamine in low doses in subjects with impaired LV causes no significant heart rate acceleration and no progression in contractility disorders, improves LV diastolic function, expressed by early diastolic blood flow towards the apex (inflow propagation) acceleration. 2. Dobutamine in low dose increases mitral A wave velocity caused by improvement of LV diastolic function and/or improvement of LA contractility.
Adult↗