PMID- 19609896
OWN - NLM
STAT- MEDLINE
DCOM- 20100222
LR  - 20211020
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 32
IP  - 7
DP  - 2009 Jul
TI  - Wall motion abnormalities with low-dose dobutamine predict a high risk of cardiac 
      death in medically treated patients with ischemic cardiomyopathy.
PG  - 403-9
LID - 10.1002/clc.20558 [doi]
AB  - BACKGROUND: Severe and extensive coronary artery disease is the underlying cause 
      of stress-induced wall motion abnormalities (SWMA) with low-dose (10 
      microg/kg/min) dobutamine suggesting that these abnormalities may identify those 
      with poor outcome. HYPOTHESIS: We assessed the prognostic value of low-dose SWMA 
      in medically treated patients with ischemic cardiomyopathy. METHODS: Low- and 
      peak-dose dobutamine echocardiography was performed in 235 patients with ischemic 
      cardiomyopathy (ejection fraction 31% +/- 8%) who were treated with medical 
      therapy. The survival of patients with low-dose SWMA (n = 33) was compared with 
      the survival of patients without ischemia (n = 85) and those with peak-dose SWMA 
      (n = 117). RESULTS: There were 123 cardiac deaths (52%) during follow-up of 4.1 
      +/- 3.3 years. Multivariate predictors of cardiac death were age (p = 0.002, 
      hazard ratio [HR]: 1.03), diabetes (p = 0.028, HR: 1.54), New York Heart 
      Association (NYHA) class III, IV heart failure (p = 0.001, HR: 1.94), the 
      presence of peak dose SWMA (p < 0.001, HR: 2.59), and low-dose SWMA (p = 0.005, 
      HR: 2.28). Survival of patients without ischemia was significantly better than 
      those with peak-dose SWMA (p < 0.0001) and those with low-dose SWMA (p = 0.001). 
      The survival of patients with low-dose SWMA was the same as those with peak-dose 
      SWMA (p = 0.89). CONCLUSIONS: Low-dose SWMA is an independent predictor of 
      cardiac mortality in medically treated patients with ischemic cardiomyopathy. 
      Patients with low-dose SWMA are at equivalent risk to those with peak-dose SWMA.
FAU - Maskoun, Waddah
AU  - Maskoun W
AD  - Department of Medicine, Indiana University School of Medicine, Krannert Institute 
      of Cardiology, Indianapolis, Indiana, USA.
FAU - Mustafa, Nowwar
AU  - Mustafa N
FAU - Mahenthiran, Jothiharan
AU  - Mahenthiran J
FAU - Gradus-Pizlo, Irmina
AU  - Gradus-Pizlo I
FAU - Kamalesh, Masoor
AU  - Kamalesh M
FAU - Feigenbaum, Harvey
AU  - Feigenbaum H
FAU - Sawada, Stephen G
AU  - Sawada SG
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Cardiovascular Agents)
RN  - 3S12J47372 (Dobutamine)
SB  - IM
MH  - Aged
MH  - Cardiomyopathies/*diagnostic imaging/drug 
      therapy/etiology/*mortality/physiopathology
MH  - Cardiovascular Agents/therapeutic use
MH  - *Dobutamine/administration & dosage
MH  - *Echocardiography, Stress
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/complications/*diagnostic imaging/drug 
      therapy/*mortality/physiopathology
MH  - Predictive Value of Tests
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/*diagnostic imaging/drug 
      therapy/etiology/*mortality/physiopathology
PMC - PMC6652903
EDAT- 2009/07/18 09:00
MHDA- 2010/02/23 06:00
PMCR- 2009/07/16
CRDT- 2009/07/18 09:00
PHST- 2009/07/18 09:00 [entrez]
PHST- 2009/07/18 09:00 [pubmed]
PHST- 2010/02/23 06:00 [medline]
PHST- 2009/07/16 00:00 [pmc-release]
AID - CLC20558 [pii]
AID - 10.1002/clc.20558 [doi]
PST - ppublish
SO  - Clin Cardiol. 2009 Jul;32(7):403-9. doi: 10.1002/clc.20558.