Dobutamine stress echocardiography response of asymptomatic patients with diabetes

Aims: This study investigated the role of dobutamine stress echocardiography for the silent diagnosis of myocardial ischemia in a diabetic population. Results from the stress test were compared between diabetic and nondiabetic groups. Methods: Forty-nine diabetics and 63 consecutive nondiabetics underwent dobutamine stress echocardiography between April and December 1999, to check for new regional wall-motion abnormalities. A single operator, using the same echograph with tissue harmonic imaging in each case, performed all the examinations, using the same techniques. Results: Significant coronary artery disease was detected in 9% of asymptomatic diabetics. Dynamic left ventricular obstruction was observed in 59% of the diabetic population and only 22% in the nondiabetic population, One patient suffered an adverse event (fast atrial fibrillation) during the stress test. Cardiac frequency at the beginning and end of the stress test differed significantly between the two populations. Conclusion: Dobutamine stress echocardiography allows for detection of silent myocardial ischemia. In the diabetic population, we describe, for the first time under dobutamine infusion, a great number of dynamic left ventricular obstructions.