Low dose dobutamine stress echocardiography predicts the improvement of left ventricular systolic function in dilated cardiomyopathy

Kitaoka, Hiroaki; Takata, Jun; Yabe, Toshikazu; Hitomi, Nobuhiko; Furuno, Takashi; Doi, Yoshinori

doi:10.1136/hrt.81.5.523

Cited by 50 publications

(35 citation statements)

References 19 publications

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“…Foi determinada a FEj final (FEj sobrecarga) e calculada a reserva contrátil. Foi considerado haver reserva contrátil quando que se verificou aumento da FEj ≥ 20% 10 . Os exames ecocardiográficos foram realizados sempre pelo mesmo operador (AG), sendo que o VAE foi retrospetivamente calculado para cada doente e também pelo mesmo operador.…”

Section: Métodosunclassified

O volume da aurícula esquerda como marcador ecocardiográfico de prognóstico em doentes com miocardiopatia dilatada

Ferreira¹,

Galrinho²,

Soares³

et al. 2013

Revista Portuguesa de Cardiologia

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Durante o seguimento, oito doentes morreram, um foi colocado em AVM e um foi transplantado. A análise de Cox univariável revelou potenciais marcadores ecocardiográficos de prognóstico na amostra tais como a dimensão da AE em modo M (HR-1,12; IC: 0,99-1,26; p = 0,067); VAE (HR-1,02; IC: 1,00-1,04; p = 0,046); VAE ajustado à superfície corporal (HR-1,03; IC: 1,00-1,07; p = 0,049); E/A (HR-0,99; IC: 0,99-1,81; p = 0,060); E/A > 2 (HR-7,00; IC:1,48-32,43; p = 0,014) e E/E' mitral (HR-1,04; IC: 1,00-1,09; p = 0,074). Na análise multivariável a única variável que permaneceu no modelo foi o VAE com o ponto de corte de 63 ml 7, IC: 0,61, p = 0,05 Objective: To evaluate the long-term prognostic value of LA volume (LAV) in patients with DCM. Methods: We prospectively studied patients admitted from January to December 2004 with a diagnosis of DCM, in sinus rhythm. Complete echocardiographic study at rest and after pharmacological stress was performed in all patients. The composite endpoint of mechanical ventricular assistance (MVA), heart transplantation or death during follow-up was assessed by univariate and multivariate analysis using a Cox regression model. Results: The study population consisted of 35 patients (68.6% male, mean age 52.0) with DCM, 82.9% of non-ischemic etiology. Ejection fraction (EF) at rest was 31.1±9.4%.During follow-up, eight patients died, one was placed on MVA and one underwent transplantation. Univariate Cox analysis showed various potential echocardiographic markers of prognosis in our population, including LA size in M-mode (HR 1.12, CI: 0.99-1.26, p=0.067), LAV (HR 1.03, CI: 1.00-1.07, p=0.046), LAV adjusted for body surface area (HR 1.03, CI: 0.99-1.26, p=0.049), E/A ratio (HR 0.99; CI: 0.99-1.81; p=0.060); E/A >2 (HR 7.00, CI: 1.48-32.43, p=0.014) and mitral E/E' ratio (HR 1.04, CI: 1.00-1.09, p=0.074).The only variable that remained in the multivariate model was LAV, with a cut-off value of 63 ml (HR 7.7, p=0.05). Conclusions: LAV was the only echocardiographic determinant of MVA, heart transplantation or death in our population with DCM. The echocardiographic parameters commonly used for risk stratification such as EF, left ventricular end-diastolic diameter and contractile reserve did not show prognostic significance in our study.

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Section: Métodosunclassified

O volume da aurícula esquerda como marcador ecocardiográfico de prognóstico em doentes com miocardiopatia dilatada

Ferreira¹,

Galrinho²,

Soares³

et al. 2013

Revista Portuguesa de Cardiologia

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“…We need to determine the responses to therapy that lead to a good prognosis in patients with DCM. 37,[41][42][43][44] Exercise testing, in combination with echocardiographic monitoring, may be an attractive and practical method of obtaining accurate information that can aid in the assessment of contractile reserve and prognosis. 38) Observations from previous studies have shown that the capacity for exercise in patients with advanced HF may in fact be more closely related to RV rather than LV performance.…”

Section: )mentioning

confidence: 99%

Prognostic Significance of Right Ventricular Dimension on Acute Decompensation in Chronic Left-Sided Heart Failure

et al. 2011

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SummaryRight ventricular (RV) dysfunction has been discussed in relation to an adverse outcome in heart failure (HF). The aim of this study was to analyze the relationship between RV function with HF exacerbation and its subsequent longterm outcome in patients with chronic left-sided HF.We studied 122 consecutive patients who were admitted for dyspnea due to exacerbated left-sided HF with a left ventricular (LV) ejection fraction of less than 40%. Conventional echocardiography was performed in the study subjects on admission and at discharge. Cox proportional hazards analysis revealed that RV end-diastolic dimension (RVDd) (hazard ratio 1.131, P = 0.005, 95% confidence interval 1.039-1.231) and the serum level of creatinine on admission were independent predictors of subsequent cardiac-related death, but RVDd at discharge and other LV parameters were not. Thus, patients were divided into tertiles on the basis of RVDd on admission: < 32 mm (n = 37), 32-40 mm (n = 43), and ≧ 40 mm (n = 42). According to the increase in the RVDd category, the cardiac-related death-free rate significantly decreased. Among the 3 groups, the pulse pressure and serum total bilirubin levels that demonstrated low cardiac output syndrome (LOS) parameters had significant differences.RVDd on admission could be measured noninvasively and easily to predict a worse long-term prognosis of chronic left-sided HF on admission, and showed correlations with LOS parameters. (Int Heart J 2011; 52: 119-126)

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“…Measures of contractile reserve include SF, EF, posterior wall thickening, wall-motion score index [53,54], change in end-systolic volume [54,55], end-systolic stress and VcFc [56,57], cardiac power [12,56,58], and changes in SI [53,57]. Studies using dobutamine stress echocardiography in adults with nonischemic DCM have demonstrated that measures of contractile reserve may correlate with functional capacity and peak oxygen consumption (VO 2 ) [55,57], as well as prognosis and recovery of LV function [59,60], and survival [54,58,61]. Few studies are published in the pediatric population regarding stress echocardiography and assessment of myocardial contractile reserve, with most studies focused on pediatric patients with anthracycline exposure [62,63].…”

Section: Stress Echocardiographymentioning

confidence: 99%

Dilated Cardiomyopathy and Myocarditis

Spencer

2009

Echocardiography in Pediatric and Congenital Heart Disease

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Low dose dobutamine stress echocardiography predicts the improvement of left ventricular systolic function in dilated cardiomyopathy

Abstract: (Heart 1999;81:523-527)

Cited by 50 publications

References 19 publications

O volume da aurícula esquerda como marcador ecocardiográfico de prognóstico em doentes com miocardiopatia dilatada

O volume da aurícula esquerda como marcador ecocardiográfico de prognóstico em doentes com miocardiopatia dilatada

Prognostic Significance of Right Ventricular Dimension on Acute Decompensation in Chronic Left-Sided Heart Failure

Dilated Cardiomyopathy and Myocarditis

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