Assessment of right ventricular function during dobutamine stress echocardiography

Dobutamine induced changes in right ventricular (RV) function have not been reported. RV end diastolic and end systolic cavity areas were manually traced in apical 4-chamber view at rest and at peak stage of Dobutamine stress echocardiography (DSE). RV area ratio (RVAR) was calculated: [RV diastolic area -RV systolic area/RV diastolic area] × 100. Three groups of pts were analyzed Group I, 20 pts, had normal LV function at rest and at peak DSE; Group II, 20 pts with previous inferior myocardial infarction (MI), 8 pts bad positive DSE for LV ischemia; Group III, 13 pts with previous anterior MI, 3 pts had positive DSE for LV ischemia. Mean ± SD LV ejection fraction (LVEF) and RVAR were: LVEF(%) RVAR (cm²) Group Rest DSE Rest DSE P I 58.5±3.2 * 73.1±2.9 * 46.8±11.1 55.9±10.2 <0.01 II 52.5±9.5 65.2±9.9 44.1±7.7 44.6±12.6** NS III 54.6±9.6 67.6±9.7 47.9±8.6 55.3±8.0 <0.05 * P<0 05 compared to II/III **p<0.01 compared to I/II All pts in group I had an increase in RVAR, 7 of 20 pts (35%) in group II decreased RVAR and 1 of 13 pts (8%) in group III decreased RVAR at peak DSE. Four of seven pts with abnormal RVAR in group II had ECG evidence of previous RV infarction. Right ventricular area ratio changes appear useful in assessment of RV function during DSE. A higher incidence of dobutamine induced RV dysfunction was observed in pts with previous inferior MI.