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Feasibility of semi-quantitative assessment of left ventricular contractile reserve in dilated cardiomyopathy.
MedLine Citation:
PMID:  22407437     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: We and others have shown previously that left ventricular (LV) contractile reserve assessed quantitatively by high-dose dobutamine stress-echocardiography (DSE) has prognostic implications in patients with dilated cardiomyopathy. PURPOSE: To assess the feasibility of semi-quantitative assessment of LV contractile reserve by differently skilled operators in patients with dilated cardiomyopathy. METHODS: High-dose DSE was performed in 63 consecutive patients, mean age 50 ± 10 years and ejection fraction (EF) 19 ± 8%. LVEF was calculated 1) using Simpson's biplane formula, and 2) semi-quantitatively (5% increments) by novice and experienced echocardiographers, and by a DSE expert. Patients were considered to have preserved LV contractile reserve if LVEF dobutamine-induced change was ≥5%. RESULTS: Twenty-seven (45.8%) patients died during the 5-year follow-up. The feasibility of the assessment was 89%, 94%, and 98% for novice and experienced readers and DSE expert, respectively. Kaplan-Meier analysis showed that LV contractile reserve assessed semi-quantitatively by DSE expert and experienced reader achieved the best prognostic separation (log rank 19.63 and 18.99, respectively, p < 0.001 for both), followed by quantitative assessment (log rank 9.76, p = 0.0018) and assessment by novice reader (log rank 8.76, p = 0.012). Areas under the curves were similar for quantitative and semi-quantitative assessment of LV contractile reserve. CONCLUSIONS: Our data indicate that semi-quantitative assessment of LV contractile reserve is feasible by differently skilled operators. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2012;
Authors:
Petar Otasevic; Nebojsa Tasic; Radoslav Vidakovic; Srdjan Boskovic; Djordje Radak; Bosko Djukanovic; Lazar Angelkov; Nada Kostic; Zorica Caparevic; Zorana Vasiljevic-Pokrajcic
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-10
Journal Detail:
Title:  Journal of clinical ultrasound : JCU     Volume:  -     ISSN:  1097-0096     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401663     Medline TA:  J Clin Ultrasound     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
"Dr Aleksandar D. Popovic" Cardiovascular Research Center, Dedinje Cardiovascular Institute and Belgrade University Medical School, Belgrade, Serbia.
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