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Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice
15:45

Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice

Published on: February 10, 2013

Effect of dobutamine stress on left ventricular filling in ischemic dilated cardiomyopathy: pathophysiology and

Alison M Duncan1, Eric Lim, Derek G Gibson

  • 1Department of Echocardiography, Royal Brompton Hospital, London, United Kingdom. a.duncan@imperial.ac.uk

Journal of the American College of Cardiology
|August 2, 2005
PubMed

Insights

Persistent restrictive filling pattern during stress in ischemic cardiomyopathy indicates higher left atrial pressure and reduced survival. Stress echocardiography identifies these high-risk patients.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • The prognostic implications of restrictive filling patterns (RFP) during stress in ischemic cardiomyopathy (ICM) are not well understood.
  • Assessing left ventricular (LV) filling dynamics under stress is crucial for risk stratification in ICM.

Purpose of the Study:

  • To investigate the impact of dobutamine on LV filling in patients with ICM.
  • To evaluate the prognostic significance of a restrictive filling pattern (RFP) detected at peak stress in ICM.

Main Methods:

  • Doppler echocardiography was used to assess 69 ICM patients at rest and during stress.
  • Restrictive filling pattern (RFP) was defined by E:A ratio ≥1.0, isovolumic relaxation time (IVRT) <80 ms, and E-wave deceleration time (EDT) <120 ms.

Main Results:

  • Of 69 patients, 42 had RFP at rest; 18 (EE) showed persistent RFP during stress, while 24 (EA) reverted to non-RFP. 27 patients (AA) had non-RFP at both rest and stress.
  • Persistent RFP (EE) was associated with increased left atrial (LA) pressure, attenuated LV inotropic response, and significantly reduced 3-year survival (49%) compared to non-RFP (AA, 89%) and reverted RFP (EA, 79%).
  • The hazard ratio for EE versus AA was 9.5 (p < 0.001), indicating a substantially higher risk of adverse events.

Conclusions:

  • Persistent restrictive filling during stress in ICM signifies elevated LA pressure and diminished LV function, leading to markedly reduced survival.
  • Stress echocardiography is a valuable tool for identifying high-risk ICM patients with persistent RFP.
  • These findings highlight the prognostic importance of dynamic LV filling assessment in ICM.
Abstract

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