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Effects of Isoproterenol Administration in Dobutamine Stress Echocardiography
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  • Puja A. Patel,
  • Zachary N. Parsia,
  • Tsion Aberra,
  • Nayrana Tillman,
  • Martin Mathias,
  • Adam Newell Bohn Johnson,
  • Akanksha Girish,
  • Brototo Deb,
  • Carolina Valdiviezo,
  • Christy Kaiser,
  • Monvadi B. Srichai
Puja A. Patel
MedStar Georgetown University Hospital MedStar Washington Hospital Center Internal Medicine Residency Program
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Zachary N. Parsia
University of Virginia School of Engineering & Applied Science
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Tsion Aberra
MedStar Georgetown University Hospital
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Nayrana Tillman
MedStar Georgetown University Hospital MedStar Washington Hospital Center Internal Medicine Residency Program
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Martin Mathias
MedStar Georgetown University Hospital
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Adam Newell Bohn Johnson
Georgetown University School of Medicine
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Akanksha Girish
Georgetown University School of Medicine
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Brototo Deb
MedStar Georgetown University Hospital MedStar Washington Hospital Center Internal Medicine Residency Program
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Carolina Valdiviezo
MedStar Georgetown University Hospital
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Christy Kaiser
MedStar Georgetown University Hospital
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Monvadi B. Srichai
MedStar Georgetown University Hospital

Corresponding Author:[email protected]

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Abstract

not-yet-known not-yet-known not-yet-known unknown Objective: This study evaluated the safety and efficacy of isoproterenol administration as an adjunct for achievement of target heart rate during dobutamine stress echocardiography (DSE). Background: In DSE, optimal accuracy is achieved when a target heart rate of 85% of maximal predicted heart rate (MPHR) is attained. Although rarely studied, intravenous isoproterenol has been used as adjunct therapy to dobutamine and atropine to increase chronotropic response during pharmacologic stress testing. Methods: We identified 5569 DSE studies during which 264 received isoproterenol at MedStar Georgetown University Hospital from August 2011- March 2023. Of the studies receiving isoproterenol, we collected clinical and echocardiographic parameters from each study to assess the effects of isoproterenol administration, including downstream events. Results: In 264 examinations with isoproterenol, 169 (64%) achieved 85% MPHR, 103 (39%) developed premature ventricular contractions, 79 (30%) developed symptoms including nausea/vomiting in 44 (17%), and chest pain in 15 (6%). There was hypertensive response to stress in 53 studies (20%) and hypotensive response in 37 studies (14%). There was no significant increase in 30 day and 1 year death when compared to studies that did not receive isoproterenol. Conclusions: Isoproterenol can effectively be used as an adjunctive agent in DSE to achieve the requisite hemodynamic stress for evaluation of ischemia, with a similar rate of side effects and complications when compared to dobutamine and atropine stress testing.
19 Nov 2024Submitted to Echocardiography
22 Nov 2024Submission Checks Completed
22 Nov 2024Assigned to Editor
22 Nov 2024Review(s) Completed, Editorial Evaluation Pending
22 Nov 2024Reviewer(s) Assigned