Yoshihisa Matsumura1, Jun Takata1, Hiroaki Kitaoka1, Tomoyuki Hamada1, Makoto Okawa1, Toru Kubo1, Yoshinori Doi2. 1. Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Oko, Nankoku, Kochi, 783-8505, Japan. 2. Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Oko, Nankoku, Kochi, 783-8505, Japan. ydoi@med.kochi-u.ac.jp.
Abstract
PURPOSE: It is unclear whether left ventricular (LV) contractile reserve assessed by low-dose dobutamine stress echocardiography (DSE) can predict the long-term prognosis together with LV functional changes in patients with idiopathic dilated cardiomyopathy (DCM). METHODS AND RESULTS: Contractile reserve was determined in 28 patients with DCM, and was then compared with changes in LV fractional shortening (FS) and cardiac events during a follow-up period of 68 ± 43 months. Nine events (2 sudden deaths, 5 heart failure deaths, and 2 rehospitalizations for heart failure) were observed. FS at peak dose was lower in patients with events (events group) than in those without events (no-events group) (20 ± 6 vs. 27 ± 7%; P < 0.05), although there were no differences in FS at baseline between the two groups. FS at follow-up was lower in the events group than in the no-events group (14 ± 7 vs. 21 ± 8%; P < 0.05). The change in FS during DSE (FS at peak dose/baseline) correlated with the change in FS during the follow-up time (FS at follow-up/baseline), and it was a predictor of events by multiple regression analysis. CONCLUSIONS: LV contractile reserve assessed by low-dose DSE is a useful marker not only to predict LV functional improvement, but also to determine the long-term prognosis in patients with DCM.
PURPOSE: It is unclear whether left ventricular (LV) contractile reserve assessed by low-dose dobutamine stress echocardiography (DSE) can predict the long-term prognosis together with LV functional changes in patients with idiopathic dilated cardiomyopathy (DCM). METHODS AND RESULTS: Contractile reserve was determined in 28 patients with DCM, and was then compared with changes in LV fractional shortening (FS) and cardiac events during a follow-up period of 68 ± 43 months. Nine events (2 sudden deaths, 5 heart failure deaths, and 2 rehospitalizations for heart failure) were observed. FS at peak dose was lower in patients with events (events group) than in those without events (no-events group) (20 ± 6 vs. 27 ± 7%; P < 0.05), although there were no differences in FS at baseline between the two groups. FS at follow-up was lower in the events group than in the no-events group (14 ± 7 vs. 21 ± 8%; P < 0.05). The change in FS during DSE (FS at peak dose/baseline) correlated with the change in FS during the follow-up time (FS at follow-up/baseline), and it was a predictor of events by multiple regression analysis. CONCLUSIONS: LV contractile reserve assessed by low-dose DSE is a useful marker not only to predict LV functional improvement, but also to determine the long-term prognosis in patients with DCM.
Authors: T M Ramahi; M D Longo; A R Cadariu; K Rohlfs; M Slade; S Carolan; E Vallejo; F J Wackers Journal: Eur Heart J Date: 2001-05 Impact factor: 29.983
Authors: Marco Metra; Savina Nodari; Giovanni Parrinello; Raffaele Giubbini; Carlo Manca; Livio Dei Cas Journal: Am Heart J Date: 2003-02 Impact factor: 4.749
Authors: J L Dubois-Randé; P Merlet; F Roudot; C Benvenuti; S Adnot; L Hittinger; A M Duval; A Syrota; A Castaigne; D Loisance Journal: Am Heart J Date: 1992-09 Impact factor: 4.749