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Updated: Apr 28, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Prognostic value of left ventricular volume response during dobutamine stress echocardiography
Insights
An abnormal left ventricular end-diastolic volume response during dobutamine stress echocardiography indicates a higher risk of cardiac events. This finding helps identify patients needing closer monitoring and prognostic evaluation.
Area of Science:
- Cardiology
- Echocardiography
- Cardiac Imaging
Background:
- Dobutamine stress echocardiography (DSE) is a key tool for assessing coronary artery disease.
- Left ventricular (LV) volume changes during DSE can reflect myocardial function and ischemia.
- Identifying prognostic markers in DSE is crucial for patient management.
Purpose of the Study:
- To evaluate the prognostic significance of LV volume changes during DSE.
- To assess the predictive value of abnormal LV volume response for cardiac events.
- To compare LV volume response with other clinical and stress test variables.
Main Methods:
- 136 patients undergoing DSE were studied.
- LV end-diastolic and end-systolic volumes were analyzed.
- Abnormal responses were defined as <10% decrease in end-diastolic volume and <20% decrease in end-systolic volume.
- Follow-up for spontaneous cardiac events (hard and soft) was conducted over 18 months.
Main Results:
- 31 cardiac events occurred during follow-up.
- Abnormal end-diastolic volume response (P=0.006) and end-systolic volume response (P=0.039) were associated with increased cardiac events.
- Diabetes (P=0.008) and inducible angina (P=0.038) also predicted events.
- Cox regression identified abnormal end-diastolic volume response and diabetes as independent predictors of spontaneous cardiac events.
Conclusions:
- An abnormal end-diastolic volume response during DSE is a significant indicator of an unfavorable prognosis.
- Patients with abnormal LV volume response require further prognostic assessment.
- These findings aid in stratifying risk for patients with suspected or known coronary artery disease.
Aims:
An abnormal left ventricular volume response during dobutamine echocardiography identified patients with severe coronary artery disease. The aim of the study was to assess the prognostic value of left ventricular volume changes during dobutamine stress echocardiography in 136 patients.
Methods And Results:
Endpoints were defined as spontaneous cardiac events at follow-up. Left ventricular end-diastolic and end-systolic volume changes (abnormal response: < 10% and < 20% decrease, respectively) were compared with other clinical and stress test variables. During 18 +/- 7 months of follow-up, 31 cardiac events occurred: 12 hard events (cardiac death [n = 6], myocardial infarction [n = 6]) and 19 soft events (unstable angina [n = 16], congestive heart failure [n = 3]). End-diastolic volume response (P = 0.006), diabetes (P = 0.008), inducible wall motion abnormalities (P = 0.024), end-systolic volume response (P = 0.039) and inducible angina (P = 0.038) were related to a greater likelihood of cardiac events. The Cox regression analysis revealed end-diastolic volume response (odds ratio: 3.0; CI 1.44-6.32) and diabetes (odds ratio: 2.7; CI 1.28-5.69) to be independent predictors of spontaneous cardiac events. Diabetes (odds ratio: 4.0; CI 1.26-12.80) and < 40% baseline ejection fraction (odds ratio: 2.21; CI1.14-4.29) were independent predictors of hard events.
Conclusion:
An abnormal end-diastolic volume response during dobutamine stress echocardiography identifies patients with an unfavourable outcome; they should be considered for more accurate prognostic stratification.
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