Quantitative Assessment of Left Ventricular Function During Contrast-Enhanced Dobutamine Stress Echocardiography Predicts Future Cardiac Events in Diabetic Patients

Abstract

Background Non-invasive diagnosis and risk stratification of coronary artery disease are important for the selection and optimization of therapeutic interventions in diabetic patients, which may improve survival. The aim of this study was to determine the incremental value of contrast-enhanced dobutamine stress echocardiography (CE-DSE) for risk stratification. Methods and Results CE-DSE was performed in 326 patients with diabetes mellitus (mean age; 66±10 years, 223 men). All patients were followed up for a mean of 29 months (1-61 months). Dobutamine was infused in a standard protocol with an intravenous contrast agent. The primary endpoints for hard cardiac events included cardiac death and nonfatal myocardial infarction. The primary endpoints for total cardiac events included hard cardiac events, unstable angina pectoris, congestive heart failure, and late coronary revascularization (>3 months). Cardiac events occurred in 74 patients. The addition of the CE-DSE results, including abnormal left ventricular end-systolic volume response and left ventricular ejection fraction at peak stress <50%, to the clinical and rest echocardiography model provided incremental information in predicting total cardiac events (increase in chisquare value for the model from 17 to 24, p<0.05) and hard cardiac events (increase in chi-square value for the model from 18 to 24, p<0.05). Conclusions Quantitative assessment of left ventricular function during CE-DSE provides incremental prognostic information in predicting cardiac events in diabetic patients. (Circ J 2006; 70: 868 -874)

Pocket-Sized Transthoracic Echocardiography Device for the Measurement of Cardiac Chamber Size and Function

“…[10][11][12][13] An expensive high-end instrument is used in the echocardiographic laboratory, operated by a skilled sonographer and supervised by experienced physicians. Echocardiographic examination is, therefore, performed several days after the initial physician-patient encounter.…”

Effects of Gender on Prognosis of Patients With Known or Suspected Coronary Artery Disease Undergoing Contrast-Enhanced Dobutamine Stress Echocardiography

“…4,5 Use of intravenous ultrasound contrast agents during stress echocardiography has the potential to improve accuracy in the detection of CAD, 6 as well as in the determination of prognosis. 7,8 However, gender differences in the predictors of outcome in patients with known or suspected CAD undergoing contrast-enhanced (CE)-DSE have not been determined and was the aim of this study.…”