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Low dose dobutamine stress echocardiography predicts the improvement of left ventricular systolic function in dilated
1Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.
Insights
Dobutamine stress echocardiography can predict left ventricular systolic function improvement in dilated cardiomyopathy (DCM) patients. Changes in function during stress correlate with long-term outcomes, aiding prognosis.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure
Background:
- Dilated cardiomyopathy (DCM) is characterized by impaired left ventricular systolic function.
- Predicting functional recovery in DCM is crucial for patient management and treatment strategies.
Purpose of the Study:
- To evaluate dobutamine stress echocardiography (DSE) as a predictor of left ventricular systolic function improvement in DCM patients.
- To assess the correlation between myocardial contractile reserve assessed by DSE and long-term functional changes.
Main Methods:
- 18 DCM patients underwent DSE to assess myocardial contractile reserve.
- Left ventricular ejection fraction (LVEF) and regional wall motion scores were analyzed before and during dobutamine infusion.
- Changes in LVEF and wall motion were compared with outcomes over a 15-month follow-up period.
Main Results:
- Patients who improved LVEF (>20%) at follow-up showed a significantly greater improvement in wall motion score during dobutamine infusion compared to non-improvers.
- The percentage change in LVEF during dobutamine stress strongly correlated with the change in LVEF during the follow-up period (r=0.74, p<0.001).
Conclusions:
- Dobutamine stress echocardiography is a valuable tool for predicting the improvement of left ventricular systolic function in DCM.
- Assessing changes in left ventricular systolic performance during low-dose dobutamine stress can guide prognosis in DCM patients.
Objective:
To determine whether dobutamine stress echocardiography can predict the improvement of left ventricular systolic function in patients with dilated cardiomyopathy (DCM).
Methods:
Myocardial contractile reserve, as assessed by dobutamine stress echocardiography, was determined in 18 patients with DCM (mean (SD) age 53 (13) years, left ventricular ejection fraction (LVEF) 28 (10)%) and compared with changes in LVEF during a follow up period of 15 (8) months. The LVEF and regional left ventricular wall motion score (0, normal to 4, dyskinesis) of 12 segments in short axis and four chamber views were analysed before and after dobutamine infusion (5-20 microg/kg/min).
Results:
During a follow up period of 15 (8) months, a significant improvement in LVEF (> 20%) was found in seven patients but not in the remaining 11. Baseline haemodynamic findings were similar in both groups. Patients with an improvement in follow up LVEF showed a greater change in wall motion score from baseline during dobutamine infusion than patients with no improvement (at rest, 1.7 (0.4) v 1.9 (0.2), NS; dobutamine 10 microg/kg/min, 0.6 (0.4) v 1.2 (0.4), p < 0.05). The percentage change in LVEF during dobutamine infusion was also significantly greater in patients who showed improvement than in those who did not. The change in LVEF during the follow up period (follow up LVEF/baseline LVEF) correlated well with the change in LVEF during dobutamine stress (LVEF at rest/LVEF at dobutamine 10 microg/kg/min; r = 0.74, p < 0.001).
Conclusions:
Changes in left ventricular systolic performance during low dose dobutamine stress echocardiography are a useful marker to predict the outcome of left ventricular systolic function in patients with DCM.