Dobutamine in differential diagnosis of noncoronary myocardial diseases

M.N. Gulmatova, M.E. Radjabov*, F.I. Odinaev, S.F. Odinaev

Chair of Internal diseases №1 Avicenna TSMU
* Republican Clinical Cardiology Center MH RT

For differential diagnosis of coronary heart disease (CHD) and noncoronary myocardial diseases (NMD), the method of stress echocardiography with dobutamine stress test was used. CHD patients on a background of dobutamine improve intracardiac hemodynamics (ICSV CDSLV), ejection fraction increased from 52% to 61.5%, which indicates an increase in total myocardial contractility. However, the index of left ventricular contractility), reflecting the regional contractility of the left ventricle increased from 1,12 ± 0,06 to 1,51 ± 0,07 units, indicating an increasing number of segments with impaired contractility. From the 170 segments of normokinesis 5 segments lose their ability to contract normally and change to hypokinesis, from 35 segments with revealed hypokinesis before stress testing 4 segments are transforming into akinetic segments; from 20 segments with akinesia 2 segments turn into persistent dyskinesia.

In contrast to patients with coronary artery disease in patients with NMD overall myocardial contractility with dobutamine improves, but to a lesser degree, and ILVC decreases from 1,29 ± 0,06 to 1,05 ± 0,03 units, indicating a decrease in the number segments with impaired contractility. In practice, different effect of dobutamine in patients with coronary artery disease and NMD can be used for differential diagnosis.

Keywords: dobutamine, stress test, stress echocardiography.

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