Document Detail

Right vs. left ventricular contractile reserve in one-year prognosis of patients with idiopathic dilated cardiomyopathy: assessment by dobutamine stress echocardiography.
MedLine Citation:
PMID:  16293529     Owner:  NLM     Status:  MEDLINE    
AIM: To determine prognostic implications of the assessment of right (RV) vs. left ventricular (LV) contractile reserve with dobutamine echocardiography in patients with idiopathic dilated cardiomyopathy. METHODS AND RESULTS: Forty-eight consecutive patients (41 male, NYHA class III/IV 13 patients, LV ejection fraction 19+/-8%) were subjected to dobutamine stress echocardiography in incremental stages lasting 5 min each. Contractile reserve was defined as the difference between the values of LV ejection fraction and RV fractional area change obtained at peak dobutamine dose and the baseline values. Patients were followed for one year after enrollment for combined end-point of cardiac death, partial left ventriculectomy and hospitalization for congestive heart failure. During the follow-up 15/48 patients reached combined end-point. Patients who reached end-point had lower RV and LV contractile reserves (14+/-5 vs. 8+/-6%, p=0.0014, and 9+/-5 vs. 3+/-2%, p<0.001, respectively). Kaplan-Meier curves demonstrated that both LV and RV contractile reserves can identify patients with dismal prognosis (log rank=17.02 and log rank=14.66, respectively, p<0.001 for both). Multivariate analysis identified dobutamine induced change in LV functional reserve as the only independent predictor of combined end-point (beta=-0.63, p=0.0035). CONCLUSION: Both RV and LV contractile reserves can be used for prognostic stratification in patients with idiopathic dilated cardiomyopathy. It appears that dobutamine induced change in LV functional reserve may better identify patients with dismal prognosis.
Petar Otasević; Zoran Popović; Lorenza Pratali; Alja Vlahović; Jovan D Vasiljević; Aleksandar N Nesković
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Publication Detail:
Type:  Journal Article     Date:  2005-03-31
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  6     ISSN:  1525-2167     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-11-18     Completed Date:  2006-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  429-34     Citation Subset:  IM    
Dr. Aleksandar D. Popović Cardiovascular Research Center, Dedinje Cardiovascular Institute, Belgrade University Medical School, Milana Tepic a 1, 11040 Belgrade, Serbia and Montengro.
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MeSH Terms
Cardiomyopathy, Dilated / diagnosis,  physiopathology,  ultrasonography*
Dobutamine / diagnostic use
Echocardiography, Stress / methods,  standards*
Follow-Up Studies
Heart Ventricles / physiopathology,  ultrasonography*
Middle Aged
Multivariate Analysis
Myocardial Contraction / drug effects,  physiology*
Ventricular Dysfunction, Left / ultrasonography*
Ventricular Dysfunction, Right / ultrasonography*
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