Dobutamine may reduce cerebral blood flow when administered

1. In a cohort of young participants, dobutamine stress tests were found to reduce cerebral blood flow on magnetic resonance angiography.

Evidence Rating Level: 3 (Average)

Dobutamine is a sympathomimetic medication used in echocardiography and the acute care of congestive heart failure. Previous research has not established whether this medication impacts cerebral blood flow (CBF). This self-controlled study included 48 participants, aged 23 to 34 years, all non-smokers, with no previous cardiovascular or cerebrovascular disease. Magnetic resonance angiography (MRA) with 3D pseudo-continuous arterial spin labeling was used to assess CBF before and during a dobutamine stress test. MRA results were independently assessed by two radiologists. Compared to the resting state, CBF was significantly lower in both gray and white matter during the stress test, particularly in the anterior circulation (voxel level P<0.001, pixel level P<0.05). Factors associated with a greater reduction in cerebral blood flow during the test included high BMI (OR, 5.80; 95% CI, 1.60–21.01; P=0.008) and lower systolic blood pressure (SBP) (OR, 0.64; 95% CI, 0.45–0.92; P=0.014). This study determined that dobutamine-induced stress decreased CBF, particularly in the anterior brain of those with higher BMIs and low SBP. Given that the study only included young, healthy adults, the results cannot be generalized to a broader population. Further research is needed to determine whether dobutamine impacts CBF when used for patients who are older or those with chronic conditions, including congestive heart failure. 

Click to read the study in BMC Medicine

Image: PD

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