Why the study?
Does low-dose dobutamine stress echocardiography predict contractile reserve and CRT response in heart failure patients eligible for CRT?
Does low-dose dobutamine stress echocardiography predict contractile reserve and CRT response in heart failure patients eligible for CRT?
Low-dose dobutamine stress echocardiography is safe and feasible in CRT candidates, with contractile reserve present in 77% of patients and inversely associated with left ventricular dilation.
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Contractile reserve less likely in more dilated ventricles among CRT candidates; leaves open its value for response prediction.
Cardiac resynchronization therapy (CRT) is an effective methodology indicated in selected heart failure patients. Identifying responders to the therapy is still challenging. Most studies report that at least 30% of the patients are nonresponders. Baseline characteristics of the Low-Dose Dobutamine Stress Echocardiography to Predict Cardiac Resynchronization Therapy Response (LODO-CRT) trial population are presented. The study investigates dobutamine stress echocardiography's role in predicting CRT response. Two hundred seventy-one CRT candidates were studied. Mean age was 67+/-10 years, 69% were male, 96% had New York Heart Association class III disease, and 39% had heart failure of ischemic etiology. Mean QRS and left ventricular ejection fraction were 146+/-24 ms and 26%+/-6%, respectively. Seventy-seven percent of participants showed contractile reserve. Left ventricular end-diastolic volume was shown to be independently associated with contractile reserve presence. In particular, more dilated ventricles are associated with a lower chance of having contractile reserve. The LODO-CRT trial enrolled a cohort of patients fulfilling criteria for CRT. Dobutamine stress echocardiography was highly feasible and safe in this population. Contractile reserve was associated with healthier ventricles.
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Iacopino et al. (2010) studied this question.
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