| Prognostic value of pharmacologic stress echocardiography in patients with idiopathic dilated cardiomyopathy: a prospective, head-to-head comparison between dipyridamole and dobutamine test. | |
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MedLine Citation:
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PMID: 18068617 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Inotropic reserve identified by dobutamine or dipyridamole stress echocardiography is associated with a better outcome in patients with idiopathic dilated cardiomyopathy (DCM), although the relative prognostic value of each remains unsettled. The purpose of the present study was to assess the relative prognostic value of dobutamine versus dipyridamole stress echocardiography for the prediction of all-cause death in patients with idiopathic DCM. METHODS AND RESULTS: Eighty-seven patients (63 were male, aged 54 +/- 12 years) with DCM and an ejection fraction less than 35% underwent both dipyridamole and dobutamine stress echocardiography on different days and in a random order. In all patients, wall motion score index and ejection fraction were evaluated at baseline and peak stress. All patients were followed up for an average of 52 months. All-cause death was identified as the prognostic end point. During the follow-up, 26 all-cause deaths occurred (29.8%). On multivariate analysis, either dobutamine echocardiography (relative risk 0.299; P = .02; 95% confidence interval 0.084-0.835) or dipyridamole echocardiography (relative risk 0.161; P < .00; 95% confidence interval 0.07-0.394) added significantly to a prognostic model based on clinical and resting echocardiographic variables. Survival was 83% in patients with dobutamine and 84% in patients with dipyridamole-induced contractile reserve. CONCLUSIONS: Dobutamine and dipyridamole stress echocardiography have similar feasibility and prognostic accuracy in DCM risk stratification. |
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Authors:
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Lorenza Pratali; Petar Otasevic; Aleksandar Neskovic; Sabrina Molinaro; Eugenio Picano |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study |
Journal Detail:
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Title: Journal of cardiac failure Volume: 13 ISSN: 1532-8414 ISO Abbreviation: J. Card. Fail. Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-12-10 Completed Date: 2008-01-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9442138 Medline TA: J Card Fail Country: United States |
Other Details:
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Languages: eng Pagination: 836-42 Citation Subset: IM |
Affiliation:
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National Council of Research, Institute of Clinical Physiology, Pisa, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiomyopathy, Dilated
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physiopathology,
ultrasonography* Cardiotonic Agents / therapeutic use* Dipyridamole / diagnostic use* Dobutamine / therapeutic use* Echocardiography, Stress / methods* Female Follow-Up Studies Humans Male Middle Aged Myocardial Contraction / physiology Prognosis Prospective Studies Reproducibility of Results Severity of Illness Index Stroke Volume / physiology Vasodilator Agents / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Cardiotonic Agents; 0/Vasodilator Agents; 34368-04-2/Dobutamine; 58-32-2/Dipyridamole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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