Dobutamine Stress Echocardiography for Left Ventricular Reverse Remodeling in Idiopathic Dilated Cardiomyopathy

Left ventricular reverse remodeling (LVRR) reflects a good prognosis in patients with idiopathic dilated cardiomyopathy (IDCM). This study aimed to evaluate the usefulness of contractile reserve on dobutamine stress echocardiography (CR-DSE) for predicting LVRR in patients with IDCM. A total of 38 patients with IDCM were enrolled between March 2014 and May 2018. All patients underwent echocardiography and cardiac magnetic resonance imaging at baseline, and echocardiography at 6 months. Among 38 patients, 22 (57.9%) exhibited CR-DSE at baseline, and 14 (36.8%) experienced LVRR at 6 months. LVRR occurred in 12 of the 22 patients with CR-DSE (54.5%) and in 2 of 16 patients without CR-DSE (12.5%) (p<0.05). In multivariate logistic regression analysis, a CR-DSE was an independent predictor of LVRR (odds ratio, 1.24; 95% confidence interval, 1.01-1.51; p=0.043). Delta LV ejection fraction during DSE also predicted LVRR (area under the curve: 0.765; p=0.007). Preserved CR-DSE was significantly associated with LVRR at 6 months, suggesting its potential utility as a functional predictor of myocardial recovery in patients with IDCM.