Document Detail


Head-to-head comparison of indices of left ventricular contractile reserve assessed by high-dose dobutamine stress echocardiography in idiopathic dilated cardiomyopathy: five-year follow up.
MedLine Citation:
PMID:  16449519     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare head to head the indices of left ventricular contractile reserve assessed by high-dose dobutamine in the five-year prognosis of patients with idiopathic dilated cardiomyopathy.
DESIGN AND SETTING: Prospective study in a tertiary care centre.
PATIENTS: 63 consecutive patients with idiopathic dilated cardiomyopathy.
INTERVENTIONS: High-dose dobutamine stress echocardiography was performed in progressive stages lasting 5 min each. Wall motion score index, ejection fraction, cardiac power output and end systolic pressure to volume ratio were evaluated as indices of left ventricular contractility.
MAIN OUTCOME MEASURE: Five-year cardiac mortality.
RESULTS: During the follow up of 59 patients, 27 (45.8%) died of cardiac causes. According to Kaplan-Meier and receiver operating characteristic analyses all indices of contractile reserve differentiated patients with respect to cardiac death. Wall motion score index achieved the best separation (log rank 21.75, p < 0.0001, area under the curve 0.84), followed by change in ejection fraction (log rank 11.25, p = 0.0008, area under the curve 0.79), end systolic pressure to volume ratio (log rank 14.32, p = 0.0002, area under the curve 0.75) and cardiac power output (log rank 9.84, p = 0.0017, area under the curve 0.71). Cox's regression model identified wall motion score index as the only independent predictor of cardiac death.
CONCLUSIONS: These data show that all examined indices of left ventricular contractile reserve are predictive of five-year prognosis, but change in wall motion score index may have the greatest prognostic potential.
Authors:
P Otasevic; Z B Popovic; J D Vasiljevic; L Pratali; A Vlahovic-Stipac; S D Boskovic; N Tasic; A N Neskovic
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-01-31
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  92     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-15     Completed Date:  2006-09-12     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1253-8     Citation Subset:  AIM; IM    
Affiliation:
Dr Aleksandar D Popovic Cardiovascular Research Center, Dedinje Cardiovascular Institute, Milana Tepića 1, 11040 Belgrade, Serbia and Montenegro. potasevic@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / physiology
Cardiac Output
Cardiomyopathy, Dilated / physiopathology*,  ultrasonography
Echocardiography, Stress / methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Contraction / physiology*
Prospective Studies
Survival Analysis
Ventricular Dysfunction, Left / physiopathology
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