Echocardiography

Relatively selective stimulation of Pi-adrenergic receptors can be achieved with dobutamine. This is a racemic drug of which both isomers activate the Pi-receptor, and in addition the (-) isomer activates ( -receptors whereas the (+) isomer activates p2-receptors the simultaneous activation of ai- and p2-receptors results in no major net effect on peripheral resistance, and thus the overall cardiovascular effects are mediated by Pi-stimulation leading to increases in cardiac contractility and output. Dobutamine is used for the short-term treatment of acute cardiac failure and for diagnostic purposes in stress echocardiography. 

A. Transthoracic echocardiography (TTE) with agitated saline contrast... 

Harloff A, Handke M, Reinhard M, Geibel A, Hetzel A. Therapeutic strategies after examination by transesophageal echocardiography in 503 patients with ischemic stroke. Stroke 2006 37 859-864. 

Wall motion abnormalities or left ventricular dilation with stress echocardiography are indicative of IHD. 

After prior anticoagulation (or after transesophageal echocardiography demonstrated the absence of a thrombus, thereby obviating the need for warfarin) methods for restoring sinus rhythm in patients with AF or atrial... 

Echocardiography is useful if the history or physical findings suggest valvular pericardial disease or ventricular dysfunction. In patients unable to exercise, pharmacologic stress echocardiography (e.g., dobutamine, dipyridamole, or adenosine) may identify abnormalities that would occur during stress. 

Transesophageal echocardiography is important in identifying and localizing valvular lesions in patients suspected of having IE. Transesophageal... 

An electrocardiogram, chest radiograph, and echocardiogram are commonly performed. Echocardiography to determine the presence of valvular vegetations plays a key role in the diagnosis of infective endocarditis it should be performed in all suspected cases. 

Monitoring for fibrotic complications should include periodic cardiac auscultation, chest x-ray, echocardiography, and abdominal magnetic resonance imaging. Patients should report symptoms of flank pain, dys-uria, chest pain, and shortness of breath. 

Ejection fraction (% of blood expelled from the ventricle during contraction), % fractional shortening (contraction of left ventricle), stroke volume Echocardiography Ozkanlar et al. 100 Tsusaki et al. 101 Hanton et al.102 ... 

Tsusaki, H., Yonamine, H., Tamai, A., Shimomoto, M., Iwao, H., Nagata, R., and Kito, G., Evaluation of cardiac function in primates using real-time three-dimensional echocardiography as applications to safety assessment, /. Pharmacol. Toxicol. Methods, 52, 182-187, 2005. 

Schiller NB, Goldstein JA (1982) Methodology in Contrast Echocardiography. In Meltzer RS, Roelandt J (eds) Contrast Echocardiography. Martinus Nijhoff Publishers, Hague, p 47... 

Bax JJ, Cornel JH, Visser FC, Fioretti PM, van LA, Reijs AE et al. Prediction of recovery of myocardial dysfunction after revascularization. Comparison of fluorine-18 fluorodeoxyglucose/thalhum-201 SPECT, thaUium-201 stress-reinjection SPECT and dobutamine echocardiography. J Am Coll Cardiol 1996 28 558-564... 

Schnittger I, Appleton CP, Hatle LK, Popp RL. Diastolic mitral and tricuspid regurgitation by Doppler echocardiography in patients with atrioventricular block new insight into the mechanism of atrioventricular valve closure. J. Am. Coll. Cardiol. 1988 11 83-8. 

Panidis IP, Ross J, Munley B, Nestico P, Mintz GS. Diastolic mitral regurgitation in patients with atrioventricular conduction abnormalities a common finding by Doppler echocardiography. J. Am. Coll. Cardiol. 1986 7 768-74. 

The diagnosis (definite or possible endocarditis) according to the 1992 Duke s criteria (see Mandell et al., 2000) is based on blood cultures and echocardiography, the patient s history and findings upon physical examination. This diagnosis should always be considered in patients presenting with fever of unknown origin, especially when they also have a heart murmur and/or normocytic, normochromic anemia. 

The fact that the microbubbles are restricted to the vascular space makes them ideal for contrast echocardiography and vascular imaging. Echocardiography is used extensively to assess ischemic heart disease. Contrast-enhanced echocardiography improves visualization of the cavities of the heart, the lumen of arteries and veins, and small vessels within solid organs and perfused tissues. Effective endocardial border delineation allows assessment of global heart function and the detection of coronary insufficiency (Fig. 12). 

H. Becher, P.N. Burns, Handbook of Contrast Echocardiography—Left Ventricular Function and Myocardial Perfusion, Springer Verlag, Berlin, 2000. 

N.C. Nanda, D.W. Kitzman, L.J. Crouse, H.C. Dittrich, Imagent improves endocardial border delineation, inter-reader agreement, and the accuracy of segmental wall motion assessment. Echocardiography 20 (2003) 151-161. 

Mechanism of Action A cardiac agent that slows impulse formation in the SA node and conduction time through the AV node. Adenosine also acts as a diagnostic aid in myocardial perfusion imaging or stress echocardiography. Therapeutic Effect Depresses left ventricular function and restores normal sinus rhythm. 

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