Document Detail


Left ventricular hypertrophy influences cardiac prognosis in patients undergoing dobutamine cardiac stress testing.
MedLine Citation:
PMID:  20442370     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study was performed to determine the utility of dobutamine stress test results for predicting myocardial infarction (MI) and cardiac death in patients with chest pain and left ventricular hypertrophy (LVH).
METHODS AND RESULTS: Three hundred fifty-three participants with a mean+/-SD age of 64+/-12 years (54%men) underwent dobutamine cardiovascular magnetic resonance stress testing and then were followed up for 6+/-2 years (mean+/-SD; range, 0.5-11.5) to assess the post-dobutamine cardiovascular magnetic resonance stress test occurrence of MI or cardiac death. LV mass and the presence or absence of ischemia were determined; LVH was defined as an LV mass index >96 g/m(2) in men and >77 g/m(2) in women. LVH was present in 62 participants (18% of the men and 17% of the women, P=0.90). Seventy-one (20%) participants experienced an MI or cardiac death during follow-up. The MI and cardiac death rate was more frequent in those with versus without LVH (32% vs 17%, P=0.009). In multivariable analysis that accounted for the presence of preexisting coronary artery disease, hypertension, diabetes, stress-induced ischemia, and reduced LV ejection fraction, LVH was an independent predictor of MI and cardiac death (hazard ratio=1.99; 95% CI, 1.13-3.50; P=0.02).
CONCLUSIONS: LVH is predictive of future MI and cardiac death in patients with or without inducible ischemia during dobutamine cardiac stress testing. As a result, LVH should be reported in those referred for dobutamine cardiac stress tests, particularly in those without inducible ischemia, in whom one would otherwise assume a favorable cardiac prognosis.
Authors:
Charaslak Charoenpanichkit; Timothy M Morgan; Craig A Hamilton; Eric L Wallace; Killian Robinson; William O Ntim; W Gregory Hundley
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-05-04
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  3     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-21     Completed Date:  2010-08-12     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  392-7     Citation Subset:  IM    
Affiliation:
Departments of Internal Medicine Cardiology Section, Public Health Sciences, Biomedical Engineering, and Radiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1045, USA.
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MeSH Terms
Descriptor/Qualifier:
Cardiotonic Agents / diagnostic use*
Chest Pain / physiopathology*
Chi-Square Distribution
Dobutamine / diagnostic use*
Female
Follow-Up Studies
Humans
Hypertrophy, Left Ventricular / physiopathology*
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Myocardial Infarction / diagnosis*,  physiopathology*
Prognosis
Proportional Hazards Models
Prospective Studies
Grant Support
ID/Acronym/Agency:
M0I-RR07122S/RR/NCRR NIH HHS; P30AG21332/AG/NIA NIH HHS; R01 HL076438-05/HL/NHLBI NIH HHS; R01HL076438/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine
Comments/Corrections

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