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