Ischemia Clinical Trial
Official title:
Comparison Of Left Ventricular Volume And Wall Stress With Dobutamine And Exercise Echocardiography
This study will compare the physiologic responses between exercise stress echocardiography and pharmacologic stress echocardiography on left ventricular volume and wall stress.
This prospective observational study will compare the physiologic responses between exercise
stress echocardiography and dobutamine stress echocardiography on left ventricular volume
and wall stress. Exercise and dobutamine stress testing are two widely employed diagnostic
modalities that are often used, interchangeably, to detect inducible ischemia. We
hypothesize that dobutamine leads to significantly lower ventricular volumes and wall stress
than exercise.
Some previous studies have shown that dobutamine and exercise echocardiography have
comparable sensitivities and specificities, differences exist between the hemodynamic
effects produced by each modality on the cardiovascular system. These variable effects may
lead to differences in left ventricular size, volume and wall stress. If divergent left
ventricular effects exist(between exercise and dobutamine induced stress), then the degree
of myocardial oxygen consumption, ischemic burden, and ischemic threshold observed during
exercise and dobutamine stress testing may be different between these commonly used
modalities of stress testing.
The potentially variable effects on the left ventricle in response to the modality used to
induce stress would highlight a physiological difference between exercise and dobutamine
stress testing. Differences in volumes and stress could also help explain the greater of
ischemia and higher frequency of angina and ST-segment deviation which has been previously
observed in some studies during exercise as compared to dobutamine echocardiography. The
presence or lack of these expected hemodynamic responses may also have additional diagnostic
and prognostic implications.
The study involves the collection of data among patients undergoing stress echocardiograms
that are clinically indicated. This data will be retrieved from the echocardiogram and
report and medical chart, including baseline clinical characteristics, exercise parameters
achieved during the test.
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Observational Model: Cohort, Time Perspective: Prospective
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