Document Detail

Prognostic significance of submaximal negative dobutamine stress echocardiography: a 3-year follow-up study.
MedLine Citation:
PMID:  18651416     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: To estimate the prognostic value of submaximal negative dobutamine stress echocardiography (NDSE) on major cardiac events. METHODS AND RESULTS: Patients with NDSE were analyzed in 2 cohorts based on predicted maximal heart rate (PMHR) (< 85% or > or = 85% PMHR) and were assessed for major adverse cardiac events over 3 years. Of 756 patients with NDSE, 415 achieved > or = 85% PMHR. Both groups had comparable ejection fractions (EF) > 50% (80.6% vs. 81.9%, p = 0.66). The NsubDSE group had higher rates of atrioventricular nodal blocker use (58.7% vs. 39.9%, p < 0.0001), and diabetes (38.7% vs. 27.6%, p = 0.001). Kaplan-Meier survival analysis showed no differences in freedom from cardiac death (98% vs. 98%, p = 0.88), nonfatal myocardial infarction (94% vs. 94%, p = 0.85), or combined major cardiac events (81% vs. 78%, p = 0.24). Diabetes and preserved ejection fraction were predictive of cardiac events in a multi-variate analysis (p = 0.005). CONCLUSIONS: In our study, NsubDSE carried a favorable prognosis. Diabetics were more likely to have an NsubDSE and suffer from a cardiac event despite a preserved ejection fraction. Hence further evaluation for coronary artery disease in this high risk cohort should be pursued.
Salil J Patel; Ajay Srivastava; Natesh Lingam; Gordon Jacobsen; Karthik Ananthasubramaniam
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology journal     Volume:  15     ISSN:  1897-5593     ISO Abbreviation:  -     Publication Date:  2008  
Date Detail:
Created Date:  2008-07-24     Completed Date:  2008-10-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  237-44     Citation Subset:  IM    
Heart and Vascular Institute, Henry Ford Hospital, Heart and Vascular Institute, K-14, Detroit, MI 48202, USA.
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MeSH Terms
Cardiotonic Agents / diagnostic use*
Dobutamine / diagnostic use*
Echocardiography, Stress*
Exercise Test
Follow-Up Studies
Heart Rate
Predictive Value of Tests
Survival Rate
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine
Comment In:
Cardiol J. 2008;15(3):207-8   [PMID:  18651411 ]

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