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Dobutamine Stress Echocardiography for Left Ventricular Reverse Remodeling in Idiopathic Dilated Cardiomyopathy
Hyun-Min Choi1, Jung-Woo Son2, Se-Eun Kim2
1Department of Cardiology, Dan Won General Hospital, Ansan, Korea.
Insights
Contractile reserve on dobutamine stress echocardiography (CR-DSE) can predict left ventricular reverse remodeling (LVRR) in idiopathic dilated cardiomyopathy (IDCM) patients. Preserved CR-DSE indicates a higher likelihood of myocardial recovery.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Heart Failure Research
Background:
- Idiopathic dilated cardiomyopathy (IDCM) is a significant cause of heart failure.
- Left ventricular reverse remodeling (LVRR) is a key indicator of positive prognosis in IDCM patients.
- Predicting LVRR is crucial for guiding therapeutic strategies and improving patient outcomes.
Purpose of the Study:
- To assess the predictive value of contractile reserve on dobutamine stress echocardiography (CR-DSE) for LVRR in IDCM.
- To identify functional markers that indicate myocardial recovery potential in IDCM.
Main Methods:
- A cohort of 38 IDCM patients underwent baseline echocardiography and cardiac magnetic resonance imaging.
- Dobutamine stress echocardiography (DSE) was performed at baseline to assess CR-DSE.
- Echocardiography was repeated at 6 months to evaluate LVRR.
Main Results:
- 57.9% of patients demonstrated CR-DSE at baseline.
- 14 patients (36.8%) achieved LVRR at 6 months.
- CR-DSE was significantly associated with LVRR (p<0.05) and identified as an independent predictor (OR 1.24, p=0.043).
Conclusions:
- Preserved CR-DSE is a significant predictor of LVRR in IDCM patients.
- CR-DSE may serve as a valuable functional tool for predicting myocardial recovery.
- This finding supports the use of DSE in managing IDCM.
Background And Objectives:
Left ventricular reverse remodeling (LVRR) reflects a good prognosis in patients with idiopathic dilated cardiomyopathy (IDCM). This study aimed to evaluate the usefulness of contractile reserve on dobutamine stress echocardiography (CR-DSE) for predicting LVRR in patients with IDCM.
Methods:
A total of 38 patients with IDCM were enrolled between March 2014 and May 2018. All patients underwent echocardiography and cardiac magnetic resonance imaging at baseline, and echocardiography at 6 months.
Results:
Among 38 patients, 22 (57.9%) exhibited CR-DSE at baseline, and 14 (36.8%) experienced LVRR at 6 months. LVRR occurred in 12 of the 22 patients with CR-DSE (54.5%) and in 2 of 16 patients without CR-DSE (12.5%) (p<0.05). In multivariate logistic regression analysis, a CR-DSE was an independent predictor of LVRR (odds ratio, 1.24; 95% confidence interval, 1.01-1.51; p=0.043). Delta LV ejection fraction during DSE also predicted LVRR (area under the curve: 0.765; p=0.007).
Conclusions:
Preserved CR-DSE was significantly associated with LVRR at 6 months, suggesting its potential utility as a functional predictor of myocardial recovery in patients with IDCM.
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