The incidence, predictors and clinical significance of hypotension during Dobutamine Stress Echo in Caribbean Patients

Issue 5 Vol: 5
DOI: 10.5083ejcm20424884.159 , Cite or Link Using DOI
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Ahmed Goha MD, Kenechukwu Mezue MD, Kristofer C. Madu, Dainia S. Baugh MD,Felix Nunura MD, Edwin Tulloch-Reid MD, Marshall Tulloch-Reid MD, and Ernest C. Madu MD


Background: Dobutamine stress echo (DSE) is widely used for diagnostic purposes in Caribbean. Safety and tolerability of DSE has been demonstrated in several studies, none of these studies have been performed in Caribbean population. Abnormal blood pressure (BP) response during DSE has been previously demonstrated and may lead to early termination of test. Ethnic variabilities are widely reported but there is no prior study in literature that explores hypotension during DSE in the Caribbean population. We sought to define the incidence, predictors and clinical significance of hypotension during DSE in a population of adults who were referred to a cardiology clinic in Jamaica.

Methods: Retrospective analysis of the data of 252 patients referred to the Heart Institute of the Caribbean, Kingston, Jamaica for DSE from 2012 to 2016.

Results: BP drop > 20 mmHg was recognized in 20.2% of patients. Hypertensive patients had statistically significant BP drop compared to normotensive patients (p < 0.034), patients presented with dyspnea had statistically significant BP drop (p < 0.046). Hypotension occurred more frequently in females, however this was not statistically significant (p = 0.088). Hypotension was not associated with abnormal DSE results.

Conclusion: This is the first study to define BP responses during DSE in Caribbean population. Incidence of BP drop with DSE was comparable to previous results of non-Caribbean patients. Hypotension with DSE is expected more in females, hypertensives and in patients presented with dyspnea. Hypotension with DSE did not have any impact on the result of DSE in Caribbean population.