PMID- 25059770
OWN - NLM
STAT- MEDLINE
DCOM- 20151124
LR  - 20220311
IS  - 1540-8175 (Electronic)
IS  - 0742-2822 (Linking)
VI  - 32
IP  - 3
DP  - 2015 Mar
TI  - Global myocardial contractile reserve assessed by high-dose dobutamine stress 
      echocardiography predicts response to the cardiac resynchronization therapy.
PG  - 490-5
LID - 10.1111/echo.12694 [doi]
AB  - BACKGROUND: Myocardial contractile reserve (CR) is a strong prognostic factor in 
      patients with heart failure. The presence of significant myocardial fibrosis can 
      lead to a reduced response to cardiac resynchronization therapy (CRT). We assumed 
      that myocardial CR assessed by high-dose dobutamine stress echocardiography (DSE) 
      would predict response to CRT. METHODS: Fifty-two consecutive symptomatic 
      patients with heart failure (New York Heart Association [NYHA] class III), with 
      depressed ejection fraction (EF) of the left ventricle (26.3 +/- 6.9%) and 
      dyssynchronous contractions (QRS duration 149.8 +/- 23.8 msec) underwent DSE before 
      CRT implantation. The difference in EF at rest and at peak (40 mug/kg per minute) 
      DSE indicated global CR. Responders to CRT were defined by a decrease in left 
      ventricular end-systolic volume of >/=15% and/or an increase in EF of >/=5% after 6 
      months of CRT. RESULTS: During high-dose dobutamine infusion, responders (28 
      patients, 54%) showed a greater increase in EF compared with nonresponders (Delta 11 
      +/- 7% vs. Delta 2 +/- 9%, P = 0.007). CR correlated moderately with an improvement in EF 
      after 6 months of CRT (r = 0.50, P = 0.0009). Furthermore, responders showed 
      significant improvement in clinical status, evaluated by a reduction in NYHA 
      functional class (-0.8 +/- 0.6 vs. 0.1 +/- 0.4, P = 0.02), compared with 
      nonresponders. A 7% exercise-induced increase in EF yielded sensitivity of 79% 
      and specificity of 87% in predicting the response to CRT after 6 months. 
      CONCLUSIONS: Myocardial CR assessed by high-dose DSE can play a potentially 
      important role in identifying responders to CRT.
CI  - (c) 2014, Wiley Periodicals, Inc.
FAU - Murin, Pavol
AU  - Murin P
AD  - Department of Cardiology, Safarik University and East-Slovak Institute of 
      Cardiovascular Diseases, Kosice, Slovak Republic.
FAU - Mitro, Peter
AU  - Mitro P
FAU - Valocik, Gabriel
AU  - Valocik G
FAU - Spurny, Peter
AU  - Spurny P
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20140724
PL  - United States
TA  - Echocardiography
JT  - Echocardiography (Mount Kisco, N.Y.)
JID - 8511187
RN  - 0 (Vasodilator Agents)
RN  - 3S12J47372 (Dobutamine)
SB  - IM
MH  - *Cardiac Resynchronization Therapy
MH  - Dobutamine/*administration & dosage
MH  - Echocardiography, Stress/*methods
MH  - Exercise Test/methods
MH  - Female
MH  - Fractional Flow Reserve, Myocardial
MH  - Heart Failure/complications/*diagnostic imaging/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Treatment Outcome
MH  - Vasodilator Agents/administration & dosage
MH  - Ventricular Dysfunction, Left/*diagnostic imaging/etiology/prevention & control
OTO - NOTNLM
OT  - cardiac resynchronization therapy
OT  - myocardial viability
OT  - stress echocardiography
EDAT- 2014/07/26 06:00
MHDA- 2015/12/15 06:00
CRDT- 2014/07/26 06:00
PHST- 2014/07/26 06:00 [entrez]
PHST- 2014/07/26 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - 10.1111/echo.12694 [doi]
PST - ppublish
SO  - Echocardiography. 2015 Mar;32(3):490-5. doi: 10.1111/echo.12694. Epub 2014 Jul 
      24.