Document Detail

Prognostic value of noninvasively obtained left ventricular contractile reserve in patients with severe heart failure.
MedLine Citation:
PMID:  9014999     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The present study sought to evaluate the prognostic value of contractile reserve measured noninvasively during dobutamine infusion in patients with severe heart failure. BACKGROUND: In patients with severe heart failure there is a great need for objective criteria to define candidates for heart transplantation or intensive medical treatment. Cardiac pumping performance reserve has been shown to have excellent prognostic value in patients with cardiogenic shock. METHODS: Cardiac peak power, an afterload-independent contractility index, was measured noninvasively at rest and at peak dobutamine inotropic stimulation. Contractile reserve was defined as the difference between maximal cardiac power at peak dobutamine dose and baseline value. Maximal cardiac power was calculated from the maximal product of validated central arterial pressure and aortic flow. RESULTS: Results were obtained from 52 subjects (42 patients, 10 control subjects). Twenty-two patients were in New York Heart Association functional classes III and IV. Of nine patients with a contractile reserve < 1.5 W/ml, eight died during the 3-year follow-up period. In contrast, all survivors had a contractile reserve > 1.5 W/ml. Using multiple logistic regression analysis, contractile reserve was shown to be the only predictor of survival. CONCLUSIONS: Contractile reserve measured noninvasively during dobutamine infusion is a valuable prognostic indicator in patients with severe heart failure, with added value to ejection fraction.
A Marmor; A Schneeweiss
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  29     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-02-27     Completed Date:  1997-02-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  422-8     Citation Subset:  AIM; IM    
Division of Cardiology, Rebecca Sieff Government Hospital, Safed and Technion Faculty of Medicine Haifa, Israel.
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MeSH Terms
Aged, 80 and over
Blood Pressure
Cardiac Output, Low / physiopathology*
Cardiotonic Agents / diagnostic use
Dobutamine / diagnostic use
Logistic Models
Middle Aged
Myocardial Contraction*
Ventricular Function, Left*
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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