According to Hotline, six Democrats voted against both versions of the stimulus package: Bobby Bright and Parker Griffith of Alabama, Walt Minnick of Idaho, Collin Peterson of Minnesota, Gene Taylor of Mississippi, and Heath Shuler.
Taylor's district only voted 32% for Obama. Bright and Minnick's gave him 36%, and Griffith's gave him 38%. Those are some of the most conservative Congressional districts in the country represented by a Democrat and the votes are understandable.
Shuler and Peterson's districts are pretty evenly split though. Each gave Obama 47% of the vote.
Looking through Swing State Project's Presidential vote by Congressional District for 2008, there are at least two dozen districts where Obama did worse than in Shuler's and Peterson's that are represented by Democrats who voted for the stimulus.
Given that, I don't think Shuler needed to vote against it politically, so he may well have done it genuinely on principle. That's certainly respectable, but I imagine a lot of involved North Carolina Democrats unsure whether they would rather see Shuler or Roy Cooper as the Democratic nominee against Richard Burr next year have now had their minds made up for them.
Of course none of that will matter if Shuler ends up being the only high profile Democrat willing to make the race next year