Safety of Dobutamine Stress Echocardiography in Patients With Left Ventricular Apical Thrombus

Cusick, David A.; Bonow, Robert O.; Chaudhry, Farooq A.

doi:10.1016/s0002-9149(97)00658-9

Cited by 8 publications

(6 citation statements)

References 17 publications

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“…However, in 1 study no thromboembolic complications were seen in patients with LV thrombus. 47 Treatment Discontinue dobutamine infusion. Hospitalization in a stroke unit should occur.…”

Section: Cerebrovascular Accidentmentioning

confidence: 99%

“…Relative contraindications include electrolyte abnormalities (hypokalemia), intraventricular thrombus, intracranial arterial aneurysm, abdominal aortic aneurysm, known severe ventricular arrhythmias, high-degree atrioventricular block, uncontrolled hypertension, atrial fibrillation, and, for atropine, obstructive uropathy. Although small DASE safety reports have been published in patients with a history of ventricular arrhythmias, 130 LV apical thrombus, 47 intracranial aneurysms, 46 and abdominal aneurysms, 131 vasodilator stress testing seems intuitively the stress test of choice in such patients. After verification of indication and exclusion of contraindications, the procedure as well as side effects and potential complications should be explained to the patient.…”

Section: Patient Selectionmentioning

confidence: 99%

“…Les contre-indications relatives comprennent les troubles électrolytiques (hypokaliémie), le thrombus intraventriculaire, l'anévrisme artériel intracrânien, l'anévrisme de l'aorte abdominale, l'existence connue d'un trouble du rythme ventriculaire sévère, le bloc auriculoventriculaire de haut degré, l'hypertension artérielle non maîtrisée, la fibrillation auriculaire et, pour l'atropine, une pathologie urologique obstructive. Bien que de petits problèmes de tolérance de l'ESDA aient été rapportés chez des patients ayant des antécédents de trouble du rythme ventriculaire, 130 de thrombus VG apical, 47 d'anévrisme intracrânien 46 ou d'anévrisme de l'aorte abdominale, 131 l'épreuve de stress par administration d'un vasodilatateur apparaît intuitivement comme la forme d'exploration de stress à privilégier chez de tels patients. Après avoir vérifié la pertinence de l'examen et l'absence de contre-indication, il convient d'expliquer au patient en quoi consiste l'exploration et à quels types d'effets indésirables et de complications elle peut donner lieu.…”

Section: Sélection Des Patientsunclassified

“…Cela étant, dans une étude, aucune complication thromboembolique n'a été observée chez les patients présentant un thrombus VG. 47 …”

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Incidence, Pathophysiology, and Treatment of Complications During Dobutamine-Atropine Stress Echocardiography

et al. 2010

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“…However, in 1 study no thromboembolic complications were seen in patients with LV thrombus. 47 Treatment Discontinue dobutamine infusion. Hospitalization in a stroke unit should occur.…”

Section: Cerebrovascular Accidentmentioning

confidence: 99%

Section: Patient Selectionmentioning

confidence: 99%

Section: Sélection Des Patientsunclassified

“…Cela étant, dans une étude, aucune complication thromboembolique n'a été observée chez les patients présentant un thrombus VG. 47 …”

unclassified

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Incidence, Pathophysiology, and Treatment of Complications During Dobutamine-Atropine Stress Echocardiography

et al. 2010

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“…[19][20][21][22] Accurate detection of the cardiac thrombus is important in patients undergoing stress tests, because safety of such procedure in the presence of thrombus is unknown. 23,24 Perfusion -CMR allows to detect cardiac thrombus with higher sensitivity than transthoracic echocardiography. 20,25 In contrary to dobutamine stress echocardiography, vasodilatators used in perfusion -CMR do not exert positive inotropic effect, which reduces potential risk of thromboembolic complications.…”

Section: R E V I E W a R T I C L Ementioning

confidence: 99%

Perfusion cardiovascular magnetic resonance as the first-line technique in patients with stable chest pain

Gawor¹,

Nagel

2020

Kardiol Pol

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Perfusion imaging with cardiovascular magnetic resonance is a noninvasive test free of ionizing radiation recommended by the latest European Society of Cardiology guidelines as one of the functional tests for coronary artery disease (CAD) detection. It has been demonstrated in numerous studies that perfusion imaging with cardiovascular magnetic resonance is highly accurate, provide strong prognostic data, and reduce the number of unnecessary invasive angiographies in patients with stable chest pain. Implementation of this method as the first-line technique in patients with stable chest pain provides an important refinement of the current concept for the assessment of CAD and in a unique way extends the diagnostic workup beyond simply ruling in or out myocardial ischemia.

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Safety of dobutamine or adenosine stress cardiac magnetic resonance imaging in patients with left ventricular thrombus

Weberling,

Seitz,

Salatzki

et al. 2023

Clin Res Cardiol

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Background Left ventricular (LV) thrombus formation is a common but potentially serious complication, typically occurring after myocardial infarction. Due to perceived high thromboembolic risk and lack of safety data, stress cardiac magnetic resonance (CMR) imaging especially with dobutamine is usually avoided despite its high diagnostic yield. This study aimed to investigate the characteristics, safety and outcome of patients with LV thrombus undergoing dobutamine or vasodilator stress CMR. Methods Patients undergoing stress CMR with concomitant LV thrombus were retrospectively included. Risk factors, comorbidities, and previous embolic events were recorded. Periprocedural safety was assessed for up to 48 h following the examination. Major adverse cardiac events (MACE) 12 months before the diagnosis were compared to 12 months after the exam and between patients and a matched control group. Additionally, patients were followed up for all-cause mortality. Results 95 patients (78 male, 65 ± 10.7 years) were included. Among them, 43 patients underwent dobutamine (36 high-dose, 7 low-dose) and 52 vasodilator stress CMR. Periprocedural safety was excellent with no adverse events. During a period of 24 months, 27 MACE (14.7%) occurred in patients and controls with no statistical difference between groups. During a median follow-up of 33.7 months (IQR 37.6 months), 6 deaths (6.3%) occurred. Type of stress agent, thrombus mobility, or protrusion were not correlated to embolic events or death. Conclusion The addition of a stress test to a CMR exam is safe and does increase the generally high cardioembolic event rate in LV thrombus patients. Therefore, it is useful to support reperfusion decision-making. Graphical Abstract

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Safety of Dobutamine Stress Echocardiography in Patients With Left Ventricular Apical Thrombus

Cited by 8 publications

References 17 publications

Incidence, Pathophysiology, and Treatment of Complications During Dobutamine-Atropine Stress Echocardiography

Incidence, Pathophysiology, and Treatment of Complications During Dobutamine-Atropine Stress Echocardiography

Perfusion cardiovascular magnetic resonance as the first-line technique in patients with stable chest pain

Safety of dobutamine or adenosine stress cardiac magnetic resonance imaging in patients with left ventricular thrombus

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