Feasibility of semi-quantitative assessment of left ventricular contractile reserve in dilated cardiomyopathy.
J Clin Ultrasound
; 40(7): 405-9, 2012 Sep.
Article
em En
| MEDLINE
| ID: mdl-22407437
ABSTRACT
BACKGROUND:
We and others have shown previously that left ventricular (LV) contractile reserve assessed quantitatively by high-dose dobutamine stress-echocardiography (DSE) has prognostic implications in patients with dilated cardiomyopathy.PURPOSE:
To assess the feasibility of semi-quantitative assessment of LV contractile reserve by differently skilled operators in patients with dilated cardiomyopathy.METHODS:
High-dose DSE was performed in 63 consecutive patients, mean age 50 ± 10 years and ejection fraction (EF) 19 ± 8%. LVEF was calculated 1) using Simpson's biplane formula, and 2) semi-quantitatively (5% increments) by novice and experienced echocardiographers, and by a DSE expert. Patients were considered to have preserved LV contractile reserve if LVEF dobutamine-induced change was ≥5%.RESULTS:
Twenty-seven (45.8%) patients died during the 5-year follow-up. The feasibility of the assessment was 89%, 94%, and 98% for novice and experienced readers and DSE expert, respectively. Kaplan-Meier analysis showed that LV contractile reserve assessed semi-quantitatively by DSE expert and experienced reader achieved the best prognostic separation (log rank 19.63 and 18.99, respectively, p < 0.001 for both), followed by quantitative assessment (log rank 9.76, p = 0.0018) and assessment by novice reader (log rank 8.76, p = 0.012). Areas under the curves were similar for quantitative and semi-quantitative assessment of LV contractile reserve.CONCLUSIONS:
Our data indicate that semi-quantitative assessment of LV contractile reserve is feasible by differently skilled operators.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cardiomiopatia Dilatada
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Função Ventricular Esquerda
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Ecocardiografia sob Estresse
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Ventrículos do Coração
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Contração Miocárdica
Tipo de estudo:
Observational_studies
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Prognostic_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Clin Ultrasound
Ano de publicação:
2012
Tipo de documento:
Article