PMID- 10400006
OWN - NLM
STAT- MEDLINE
DCOM- 19990730
LR  - 20220408
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 34
IP  - 1
DP  - 1999 Jul
TI  - Improvement of left ventricular ejection fraction, heart failure symptoms and 
      prognosis after revascularization in patients with chronic coronary artery 
      disease and viable myocardium detected by dobutamine stress echocardiography.
PG  - 163-9
AB  - OBJECTIVES: This study was designed to address, in patients with severe ischemic 
      left ventricular dysfunction, whether dobutamine stress echocardiography (DSE) 
      can predict improvement of left ventricular ejection fraction (LVEF), functional 
      status and long-term prognosis after revascularization. BACKGROUND: Dobutamine 
      stress echocardiography can predict improvement of wall motion after 
      revascularization. The relation between viability, improvement of function, 
      improvement of heart failure symptoms and long-term prognosis has not been 
      studied. METHODS: We studied 68 patients with DSE before revascularization; 62 
      patients underwent resting echocardiography/radionuclide ventriculography before 
      and three months after revascularization. Long-term follow-up data (New York 
      Heart Association [NYHA] functional class, Canadian Cardiovascular Society [CCS] 
      classification and events) were acquired up to two years. RESULTS: Patients with 
      > or =4 viable segments on DSE (group A, n = 22) improved in LVEF at three months 
      (from 27+/-6% to 33+/-7%, p < 0.01), in NYHA functional class (from 3.2+/-0.7 to 
      1.6+/-0.5, p < 0.01) and in CCS classification (from 2.9+/-0.3 to 1.2+/-0.4, p < 
      0.01); in patients with <4 viable segments (group B, n = 40) LVEF and NYHA 
      functional class did not improve, whereas CCS classification improved 
      significantly (from 3.0+/-0.8 to 1.3+/-0.5, p < 0.01). A higher event rate was 
      observed at long-term follow-up in group B versus group A (47% vs. 17%, p < 
      0.05). CONCLUSIONS: Patients with substantial viability on DSE demonstrated 
      improvement in LVEF and NYHA functional class after revascularization; viability 
      was also associated with a favorable prognosis after revascularization.
FAU - Bax, J J
AU  - Bax JJ
AD  - Department of Cardiology, University Hospital Leiden, The Netherlands. 
      Bax@cardio.azl.nl
FAU - Poldermans, D
AU  - Poldermans D
FAU - Elhendy, A
AU  - Elhendy A
FAU - Cornel, J H
AU  - Cornel JH
FAU - Boersma, E
AU  - Boersma E
FAU - Rambaldi, R
AU  - Rambaldi R
FAU - Roelandt, J R
AU  - Roelandt JR
FAU - Fioretti, P M
AU  - Fioretti PM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Cardiotonic Agents)
RN  - 3S12J47372 (Dobutamine)
SB  - IM
MH  - Aged
MH  - Cardiotonic Agents/*therapeutic use
MH  - Chronic Disease
MH  - Coronary Disease/diagnostic imaging/surgery/*therapy
MH  - *Dobutamine
MH  - Exercise Test
MH  - Female
MH  - Heart Failure/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - ROC Curve
MH  - *Stroke Volume
MH  - Treatment Outcome
MH  - Ultrasonography
MH  - Ventricular Dysfunction, Left/*physiopathology
EDAT- 1999/07/10 00:00
MHDA- 1999/07/10 00:01
CRDT- 1999/07/10 00:00
PHST- 1999/07/10 00:00 [pubmed]
PHST- 1999/07/10 00:01 [medline]
PHST- 1999/07/10 00:00 [entrez]
AID - S0735-1097(99)00157-6 [pii]
AID - 10.1016/s0735-1097(99)00157-6 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 1999 Jul;34(1):163-9. doi: 10.1016/s0735-1097(99)00157-6.