Advantages of Combining Supine Bicycle Ergometry and Dobutamine Stress Echocardiography

We investigated the impact of the addition of supine bicycle ergometry (BDT, 89 patients) to standard dobutamine stress echocardiography (DT, 101 patients) who were referred for evaluation of chest pain. Results: Target heart rate (THR) or an ischemic response (IR) was achieved in 90% of tests with BDT vs. 76% of DT, p=0.013. Normal wall motion companied by abnormal ischemic ECG response was noted in 9% of BDTs vs. 1% of DTs, p=0.028. Test duration was significantly shorter with BDTs (21.8 vs. 23.8 min in DTs, p=0.012) and maximum dobutamine dose was significantly lower (30 vs. 35 mcg/kg/min, p=0.001). Double product was significantly higher with BDTs (24988 vs. 20296 in DTs, p<0.0001). Conclusion: Addition of supine bicycle exercise to standard dobutamine echocardiographic evaluation results in more patients achieving target heart rate or ischemic response with shorter test time, lower peak dobutamine dose and higher double product.