PMID- 11741555
OWN - NLM
STAT- MEDLINE
DCOM- 20020110
LR  - 20190622
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 88
IP  - 12
DP  - 2001 Dec 15
TI  - Prognostic significance of the dobutamine echocardiography test in idiopathic 
      dilated cardiomyopathy.
PG  - 1374-8
AB  - Dobutamine stress echo provides potentially useful information on idiopathic 
      dilated cardiomyopathy (IDC). From February 1, 1997, to October 1, 1999, 186 
      patients (131 men and 55 women, mean age 56 +/- 12 years) with IDC, ejection 
      fraction <35%, and angiographically normal coronary arteries were studied by 
      high-dose (up to 40 micro/kg/min) dobutamine echo in 6 centers, all quality 
      controlled for stress echo reading. In all patients, wall motion score index 
      (WMSI) (from 1 = normal to 4 = dyskinetic in a 16- segment model of the left 
      ventricle) was evaluated by echo at baseline and peak dobutamine. One hundred 
      eighty-four patients were followed up (mean 15 +/- 13 months) and only cardiac 
      death was considered as an end point. There were 29 cardiac deaths. Significant 
      parameters for survival prediction at univariate analysis are: DeltaWMSI 
      (chi-square 20.1; p <0.0000), New York Heart Association (NYHA) class (chi-square 
      17.57; p <0.0000), rest ejection fraction (chi-square 10.41; p = 0.0013), 
      angiotensin-converting enzyme inhibitors (chi-square 8.23; p = 0.0041), and 
      hypertension (chi-square 8.08, p = 0.0045). In the multivariate stepwise analysis 
      only DeltaWMSI and NYHA were independent predictors of outcome (DeltaWMSI = 
      hazard ratio 0.02, p < 0.0000; NYHA class = hazard ratio 3.83, p < 0.0000). 
      Kaplan-Meier survival estimates showed a better outcome for patients with a large 
      inotropic response (DeltaWMSI > or =0.44, a cutoff identified by 
      receiver-operating characteristic curves analysis) than for those with a small or 
      no myocardial inotropic response to dobutamine (93.6% vs 69.4%, p = 0.00033). 
      Thus, in patients with IDC, an extensive contractile reserve identified by 
      high-dose dobutamine stress echocardiography is associated with a better 
      survival.
FAU - Pratali, L
AU  - Pratali L
AD  - C.N.R. Institute of Clinical Physiology, Pisa, Italy.
FAU - Picano, E
AU  - Picano E
FAU - Otasevic, P
AU  - Otasevic P
FAU - Vigna, C
AU  - Vigna C
FAU - Palinkas, A
AU  - Palinkas A
FAU - Cortigiani, L
AU  - Cortigiani L
FAU - Dodi, C
AU  - Dodi C
FAU - Bojic, D
AU  - Bojic D
FAU - Varga, A
AU  - Varga A
FAU - Csanady, M
AU  - Csanady M
FAU - Landi, P
AU  - Landi P
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - Cardiomyopathy, Dilated/*diagnostic imaging/mortality
MH  - *Echocardiography, Stress
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Prospective Studies
MH  - ROC Curve
MH  - Survival Rate
EDAT- 2001/12/14 10:00
MHDA- 2002/01/11 10:01
CRDT- 2001/12/14 10:00
PHST- 2001/12/14 10:00 [pubmed]
PHST- 2002/01/11 10:01 [medline]
PHST- 2001/12/14 10:00 [entrez]
AID - S0002914901021166 [pii]
AID - 10.1016/s0002-9149(01)02116-6 [doi]
PST - ppublish
SO  - Am J Cardiol. 2001 Dec 15;88(12):1374-8. doi: 10.1016/s0002-9149(01)02116-6.