Is the standard weight-based dosing of dobutamine for stress testing appropriate for patients of widely varying body mass index?

Maytinee Kittipovanonth, Alain M. Bernheim, Christopher G. Scott, Marion E. Barnes, Clarence Shub, Patricia Pellikka

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Although a gradual increase in heart rate (HR) during dobutamine stress testing (DST) is desired, few data exists regarding whether this is similarly achieved in patients of widely varying body mass index (BMI). Whether difference in BMI contributes to variation in the hemodynamic and symptomatic response to dobutamine is also unknown. Methods: From prospectively acquired data of 2776 consecutive patients who underwent DST according to standard weight-based clinical protocol, we classified patients into 4 groups of BMI (kg/m2): <25 (normal), 25 to 29.9 (overweight), 30 to 39.9 (obese), and ≥40 (severely obese) and compared the rate of increase of HR, mean blood pressure, and development of symptoms for the groups. Results: Age was 68±12 years, 52% were men, BMI was 29.8 ± 6.6 kg/m2 (range 14.5-81.4), 198 (7%) had BMI ≥40, and target HR was achieved in 2433 (88%). The rate of increase in HR was similar for each group of BMI after adjustment for age, gender, baseline HR, negative chronotropic use, and atropine administration. The percentage of patients in each group who achieved target HR was similar and the percentage of target HR achieved at each stage of dobutamine was essentially equivalent. Blood pressure responses and development of symptoms were similar in the 4 groups of BMI. Independent predictors of failure to achieve target HR included age, diabetes mellitus, treatment with negative chronotropic medications, and baseline HR; BMI was not a predictor (odds ratio [OR] 0.98, P = .086). Conclusion: The current weightbased protocol of dobutamine dosing for DST results in similar increases in HR and blood pressure for patients of widely varying BMI.

Original languageEnglish (US)
Pages (from-to)173-177
Number of pages5
JournalJournal of Cardiovascular Pharmacology and Therapeutics
Volume16
Issue number2
DOIs
StatePublished - Jun 2011

Fingerprint

Dobutamine
Body Mass Index
Heart Rate
Weights and Measures
Blood Pressure
Clinical Protocols
Atropine
Diabetes Mellitus
Hemodynamics
Odds Ratio

Keywords

  • Body mass index
  • Dobutamine
  • Obesity
  • Stress testing

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Is the standard weight-based dosing of dobutamine for stress testing appropriate for patients of widely varying body mass index? / Kittipovanonth, Maytinee; Bernheim, Alain M.; Scott, Christopher G.; Barnes, Marion E.; Shub, Clarence; Pellikka, Patricia.

In: Journal of Cardiovascular Pharmacology and Therapeutics, Vol. 16, No. 2, 06.2011, p. 173-177.

Research output: Contribution to journalArticle

Kittipovanonth, Maytinee ; Bernheim, Alain M. ; Scott, Christopher G. ; Barnes, Marion E. ; Shub, Clarence ; Pellikka, Patricia. / Is the standard weight-based dosing of dobutamine for stress testing appropriate for patients of widely varying body mass index?. In: Journal of Cardiovascular Pharmacology and Therapeutics. 2011 ; Vol. 16, No. 2. pp. 173-177.
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