Dobutamine Stress Echocardiography Ischemia as a Predictor of the Placebo-Controlled Efficacy of Percutaneous Coronary Intervention in Stable Coronary Artery Disease: The Stress Echocardiography-Stratified Analysis of ORBITA.
多巴酚丁胺负荷超声心动图缺血作为稳定冠状动脉疾病经皮冠状动脉介入治疗安慰剂对照疗效的预测因子: 负荷超声心动图-ORBITA 分层分析。
angina, stable coronary artery disease echocardiography, stress percutaneous coronary intervention
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摘要

BACKGROUND:Dobutamine stress echocardiography is widely used to test for ischemia in patients with stable coronary artery disease. In this analysis, we studied the ability of the prerandomization stress echocardiography score to predict the placebo-controlled efficacy of percutaneous coronary intervention (PCI) within the ORBITA trial (Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina).
METHODS:One hundred eighty-three patients underwent dobutamine stress echocardiography before randomization. The stress echocardiography score is broadly the number of segments abnormal at peak stress, with akinetic segments counting double and dyskinetic segments counting triple. The ability of prerandomization stress echocardiography to predict the placebo-controlled effect of PCI on response variables was tested by using regression modeling.
RESULTS:At prerandomization, the stress echocardiography score was 1.56±1.77 in the PCI arm (n=98) and 1.61±1.73 in the placebo arm (n=85). There was a detectable interaction between prerandomization stress echocardiography score and the effect of PCI on angina frequency score with a larger placebo-controlled effect in patients with the highest stress echocardiography score (Pinteraction=0.031). With our sample size, we were unable to detect an interaction between stress echocardiography score and any other patient-reported response variables: freedom from angina (Pinteraction=0.116), physical limitation (Pinteraction=0.461), quality of life (Pinteraction=0.689), EuroQOL 5 quality-of-life score (Pinteraction=0.789), or between stress echocardiography score and physician-assessed Canadian Cardiovascular Society angina class (Pinteraction=0.693), and treadmill exercise time (Pinteraction=0.426).
CONCLUSIONS:The degree of ischemia assessed by dobutamine stress echocardiography predicts the placebo-controlled efficacy of PCI on patient-reported angina frequency. The greater the downstream stress echocardiography abnormality caused by a stenosis, the greater the reduction in symptoms from PCI.
CLINICAL TRIAL REGISTRATION:URL: https://www.clinicaltrials.gov. Unique identifier: NCT02062593.

译文

背景: 多巴酚丁胺负荷超声心动图被广泛用于检测稳定性冠心病患者的缺血情况。在该分析中,我们研究了预测经皮冠状动脉介入治疗 (PCI) 的安慰剂对照疗效的术前压力超声心动图评分的能力。在 ORBITA 试验中 (稳定心绞痛血管成形术最佳药物治疗的客观随机盲法调查)。
方法: 183 例患者在随机分组前接受多巴酚丁胺负荷超声心动图检查。负荷超声心动图评分大致是压力峰值时异常节段的数量,运动节段计数为双倍,运动节段计数为三倍。通过使用回归模型测试了术前负荷超声心动图预测 PCI 对反应变量的安慰剂控制效果的能力。
结果: 术前,PCI 组的负荷超声心动图评分为 1.56 ± 1.77 (n = 98),安慰剂组为 1.61 ± 1.73 (n = 85)。在压力超声心动图评分最高的患者中,预测前压力超声心动图评分和 PCI 对心绞痛频率评分的影响之间存在可检测到的相互作用,其具有较大的安慰剂对照效应 (Pinteraction = 0.031)。根据我们的样本量,我们无法检测到负荷超声心动图评分和任何其他患者报告的反应变量之间的相互作用: 免于心绞痛 (Pinteraction = 0.116), 身体限制 (p交互作用 = 0.461),生活质量 (p交互作用 = 0.689),欧洲生活质量 5 生活质量评分 (p交互作用 = 0.789), 或压力超声心动图评分与医生评估的加拿大心血管协会心绞痛分级之间(Pinteractive = 0.693),和平板运动时间 (pinteractive = 0.426)。
结论: 多巴酚丁胺负荷超声心动图评估的缺血程度可预测 PCI 对患者报告的心绞痛频率的安慰剂控制疗效。狭窄引起的下游负荷超声心动图异常越大,PCI 引起的症状减少越大。
临床试验注册: URL: https://www.clinicaltrials.gov 。唯一标识符: nct02062593。

Dobutamine

重症 多巴酚丁胺 药物
概述  :  

多巴酚丁胺是多巴胺的衍生物制药,分子式:C18H23NO3,分子量:301.38,多巴酚丁胺能促进患者肾上腺素受体激动能力,尤其在患者内脏血管的治疗作用,能够提高患者内脏血管的可选择性扩张效果。临床应用的多巴酚丁胺是含有右旋多巴酚丁胺和左旋多巴酚丁胺的消旋体。   作用机制 多巴酚丁胺是一种选择性肾上腺素能受体兴奋剂,直接兴奋β1受体使心肌收缩力增加。Gillespie等提出,多巴酚丁胺可增强心肌梗塞、心功能减退的病人的

dobutamine [dəu'bju:təmi:n]

释义   n. 多巴酚丁胺

例句   Dopamine and Dobutamine will not work well in this situation. Early use of Adrenaline is advisable and urgent discussion with a Level 3 Consultant should be undertaken.多巴胺和多巴酚丁胺在这种情况下不会起作用。建议尽早使用肾上腺素,并与三级顾问进行紧急讨论。

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