| The additive prognostic value of restrictive pattern and dipyridamole-induced contractile reserve in idiopathic dilated cardiomyopathy. | |
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MedLine Citation:
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PMID: 16087138 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Diastolic dysfunction and lack of contractile reserve are unfavorable prognostic predictors in patients with dilated cardiomyopathy (DCM). AIMS: This study aims to assess whether diastolic dysfunction and lack of dipyridamole-induced contractile reserve were additive predictors of poor outcome in patients with DCM. METHODS: A total of 116 patients with DCM and ejection fraction (EF<35%) were studied by dipyridamole echo (0.84 mg/kg over 10 min). At rest, a restrictive filling pattern was defined as: E/A ratio >2 and an E-wave deceleration time of <140 ms on transmitral flow velocity profile. RESULTS: Rest wall motion score index (WMSI) was 2.2+/-0.3 and decreased to 1.9+/-0.41 after dipyridamole (p<0.001). During follow-up (median 26.5 months), 22 cardiac deaths occurred. At multivariate analysis, dipyridamole-induced contractile reserve yielded significant incremental prognostic value (RR=0.275, p<0.006) over NYHA class (RR=1.971, p<0.03), angiotensin-converting enzyme inhibitor therapy (RR=0.173, p<0.001), and left ventricular end-diastolic diameter (RR=1.131, p<0.001). The worst prognostic combination was the presence of restrictive pattern at rest and the absence of contractile reserve (deltaWMSI<0.15). CONCLUSION: In patients with DCM, the ominous combination of restrictive transmitral flow pattern and lack of contractile reserve during dipyridamole stress predicts an unfavourable outcome. |
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Authors:
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Lorenza Pratali; Petar Otasevic; Fausto Rigo; Sonia Gherardi; Aleksandar Neskovic; Eugenio Picano |
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Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: European journal of heart failure Volume: 7 ISSN: 1388-9842 ISO Abbreviation: Eur. J. Heart Fail. Publication Date: 2005 Aug |
Date Detail:
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Created Date: 2005-08-09 Completed Date: 2005-12-13 Revised Date: 2011-06-08 |
Medline Journal Info:
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Nlm Unique ID: 100887595 Medline TA: Eur J Heart Fail Country: Netherlands |
Other Details:
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Languages: eng Pagination: 844-51 Citation Subset: IM |
Affiliation:
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Institute of Clinical Physiology, CNR, Via G. Moruzzi no. 1, Pisa 56124, Italy. lorenza@ifc.cnr.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiomyopathy, Dilated / mortality*, physiopathology* Dipyridamole / diagnostic use Echocardiography, Stress Female Humans Male Middle Aged Myocardial Contraction Prognosis Proportional Hazards Models Prospective Studies Survival Analysis Vasodilator Agents / diagnostic use |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 58-32-2/Dipyridamole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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