| The prognostic impact of coronary flow-reserve assessed by Doppler echocardiography in non-ischaemic dilated cardiomyopathy. | |
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MedLine Citation:
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PMID: 16464914 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Coronary flow-reserve (CFR) can be impaired in non-ischaemic dilated cardiomyopathy (DCM), unmasking a coronary microcirculatory dysfunction of potential prognostic impact. The aim of the present study is to evaluate the prognostic value of Doppler echocardiographic-derived CFR in patients with DCM. METHODS AND RESULTS: We evaluated 129 DCM patients (85 male; age 62+/-11) by transthoracic dipyridamole (0.84 mg/kg in 10 min) stress echocardiography. All patients had an ejection fraction<40% (mean 32+/-7) and angiographically normal coronary arteries with NYHA class<or=3. CFR was assessed on left anterior descending artery using pulsed Doppler as the ratio of maximal peak vasodilation (dipyridamole) to rest diastolic flow velocity. All patients were followed-up for a median of 22 months. Mean CFR was 2.0+/-0.5. At individual patient analysis 46 patients had normal (CFR>2.0) and 83 had abnormal CFR. During follow-up, 18 patients died and 33 showed worsening of NYHA class. The worse event-free survival was observed in those patients with an abnormal CFR when compared with those having a normal CFR at high dose of dipyridamole (70 vs. 22%, at 75 months of follow-up, P<0.0001). In the multivariable analysis, severity of mitral insufficiency (HR=1.9, 95% CI=1.06-2.87), abnormal CFR (HR=4.0, 95% CI=1.1-15.6), resting wall motion score index (HR=6.9, 95% CI=1.5-30.7) were independent predictors of survival. CONCLUSION: In DCM patients, CFR is often impaired. A reduced CFR during vasodilator stress is an independent prognostic marker of bad prognosis. |
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Authors:
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Fausto Rigo; Sonia Gherardi; Maurizio Galderisi; Lorenza Pratali; Lauro Cortigiani; Rosa Sicari; Eugenio Picano |
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Publication Detail:
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Type: Journal Article Date: 2006-02-07 |
Journal Detail:
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Title: European heart journal Volume: 27 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2006 Jun |
Date Detail:
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Created Date: 2006-06-01 Completed Date: 2007-02-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 1319-23 Citation Subset: IM |
Affiliation:
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Cardiology Division, Umberto I Hospital, Mestre-Venice, and Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cardiomyopathy, Dilated
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mortality,
physiopathology*,
ultrasonography Coronary Circulation / physiology* Echocardiography, Doppler Echocardiography, Stress Female Follow-Up Studies Humans Male Middle Aged Stroke Volume / physiology Survival Analysis |
| Comments/Corrections | |
Comment In:
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Eur Heart J. 2006 Jun;27(11):1266-7
[PMID:
16682382
]
Eur Heart J. 2006 Aug;27(15):1884; author reply 1884-5 [PMID: 16760201 ] Eur Heart J. 2006 Nov;27(21):2607-8; author reply 2608-9 [PMID: 17030524 ] Eur Heart J. 2006 Nov;27(21):2609; author reply 2609-10 [PMID: 17030520 ] |
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