Dobutamine-induced hypotension is an independent predictor for mortality in patients with left ventricular dysfunction following myocardial infarction

Int J Cardiol. 1999 Mar 15;68(3):297-302. doi: 10.1016/s0167-5273(98)00376-3.

Abstract

Dobutamine echocardiography was performed on 297 patients after acute myocardial infarction to assess the prognostic value of dobutamine-induced hypotension in patients with left ventricular dysfunction. Patients were divided into two groups according to ejection fraction (group I, ejection fraction <0.45, n = 123; group II, ejection fraction > or =0.45, n = 174) and were followed for 20+/-8 months. Hypotension was defined as a decrease in systolic blood pressure > or =20 mm Hg, compared with baseline values. The incidence of hypotension was similar in groups I and II (23.6% vs. 18.4%, P = 0.28), and the hypotension was not related to positive dobutamine echocardiography. Univariate analysis showed that the development of hypotension was associated with a higher incidence of cardiac death in group I but not in group II. Multivariate analysis showed that dobutamine-induced hypotension was an independent predictor only for cardiac death in group I and was not related to any other cardiac events in either group. In conclusion, the development of hypotension during dobutamine stress can identify a subgroup with poor ventricular functional reserve and at high risk for cardiac death among patients complicated with left ventricular dysfunction.

Publication types

  • Clinical Trial

MeSH terms

  • Adrenergic beta-Agonists*
  • Aged
  • Blood Pressure / drug effects
  • Death, Sudden, Cardiac
  • Dobutamine*
  • Echocardiography*
  • Female
  • Humans
  • Hypotension / chemically induced*
  • Male
  • Myocardial Infarction / complications*
  • Prognosis
  • Stroke Volume / drug effects
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / mortality*

Substances

  • Adrenergic beta-Agonists
  • Dobutamine