Impact of age on the safety and the hemodynamic response pattern during high dose dobutamine echocardiography

Background: The purpose of the present study was to assess the safety and h emodynamic response of high dose dobutamine echocardiography (DE) in differ ent age groups. DE is frequently used in the diagnosis of coronary artery d isease; its safety in very elderly patients is not established, and there a re no standards for blood pressure and heart rate response. Methods and Res ults: The test was performed using up to 50 mu g/kg/min in 400 patients: 16 4 middle-aged (age < 65 years), 187 elderly (age, 65-79 years), and 49 very elderly (age greater than or equal to 80 years). It was stopped because of side effects in 91 (23%) patients. Serious side effects occurred in 1.5% o f the patients. There was a significant (60% +/- 35%) increase in, heart ra te, and a modest (10% +/- 19%) increase in the blood pressure (P < .001). T he change in heart rate was similar in the three age groups, but there was a blunting of the blood pressure response with age. Hypotension was related to ischemia only in the very old. Conclusions: High-dose dobutamine is saf e in all age groups. Dobutamine induces mainly a chronotropic and less a hy pertensive response. The chronotropic response of the very old is similar w ith that of younger patients, but the hypertensive response is blunted in t his group.