This study was performed to evaluate the feasibility of dobutamine stress as an alternative to exercise and to determine the hemodynamic variables affecting exercise capacity in patients with mitral stenosis.

Hemodynamic variables were measured using Doppler echocardiography at rest and during dobutamine stress. Measured hemodynamic variables were compared with peak oxygen uptake(peak VO2) and percent predicted peak oxygen uptake(peak %VO2) obtained by the maximal symptom-limited cardiopulmonary exercise test. Thirteen patients with isolated pure mitral stenosis in sinus rhythm.

Mean transmitral gradient(9.6±5.0mmHg to 17.3±7.6mmHg, p<0.01) and mean pulmonary artery systolic pressure(40.1±14.2mmHg to 66.4±23.1mmHg, p<0.01) increased significantly during dobutamine stress. Mean mitral valve area(0.82±0.38cm to 0.89±0.36cm, p <0.01) also increased significantly during dobutamine stress, however, changes in the area was not significantly different from the differences in intraobserver variation(0.06±0.06cm). In multivariate analysis, only pulrnonary artery systolic pressure during dobutamine stress correlated with peak VO2(r= -0.58, p<0.05) and peak %VO2(r= -0.60, p<0.05).

Dobutamine stress can be an alternative to exercise in patients with mitral stenosis and pulmonary artery systolic pressure during dobutamine stress could provide information relating to exercise capacity.