| Usefulness of Low-Dose Dobutamine Echocardiography to Predict Response and Outcome in Patients Undergoing Cardiac Resynchronization Therapy. | |
| | |
MedLine Citation:
|
PMID: 21550579 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
A substantial proportion of patients who meet the current guidelines for cardiac resynchronization therapy (CRT) fail to respond to this pacing modality. Although appropriate patient selection and left ventricular (LV) lead location have been ascribed as determinants of CRT response, the interaction among contractile reserve, dynamics of dyssynchrony, and lead location is not well understood. The present study prospectively evaluated the effect of contractile reserve and dobutamine-induced changes in LV synchrony, in relation to the LV lead location, as predictors of the response to CRT. In the present study, 31 patients were prospectively evaluated and underwent low-dose dobutamine echocardiography. The dobutamine-induced increase in ejection fraction (contractile reserve [CR]) was measured, and the most mechanically delayed segment was identified to classify patients into 2 groups. Group 1 had a CR of >20% and a LV lead position concordant with the mechanically delayed segment. Group 2 included the remaining patients (i.e., low CR, discordant LV lead position, or both). Patients in group 1 were significantly more likely to have an echocardiographic response at 6 months (80% of group 1 vs 29% of group 2, p = 0.018) and had an improved 2-year heart failure hospitalization-free survival rate (90% in group 1 vs 33% in group 2, p = 0.006). In conclusion, low-dose dobutamine echocardiography provides information that can help to predict responders to CRT. The response rates and heart failure hospitalization-free survival were improved in those patients with a CR >20% and an LV lead tip concordant with the most delayed mechanical segment. |
| | |
Authors:
|
Robert K Altman; David McCarty; Annabel A Chen-Tournoux; Francois B Tournoux; Lindsay Riedl; Mary Orencole; Mi Young Park; Michael H Picard; Jagmeet P Singh |
Related Documents
:
|
21509549 - Emergency transjugular intrahepatic portosystemic shunt (tips): results, complications ... 21166579 - Is there a role for tamsulosin after shock wave lithotripsy in the treatment of renal a... 19395059 - Nasal leech infestation in children: comparison of two different innovative techniques. 15763279 - Acoustic rhinometry in the objective evaluation of childhood septoplasties. 21479779 - Analysis of risk factors for hyperbilirubinemia occurring after hepatectomy. 11893259 - Functional endoscopic sinus surgery in the treatment of massive polyposis in asthmatic ... 11721129 - Prognostic value of soluble tumor necrosis factor receptors 1 and 2 in multiple scleros... 17785739 - Arthroscopic treatment of femoroacetabular impingement secondary to paediatric hip diso... 15534729 - Ten years experience of thoracic and thoracoabdominal aortic aneurysm surgical repair: ... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-5-6 |
Journal Detail:
|
Title: The American journal of cardiology Volume: - ISSN: 1879-1913 ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
|
Created Date: 2011-5-9 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
|
Cardiac Arrhythmia Service, Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Importance of Adjunctive Heart Failure Optimization Immediately After Implantation to Improve Long-T...
Next Document: Usefulness of Exercise-Induced Hypertension as Predictor of Chronic Hypertension in Adults After Ope...