What question did this study set out to answer?

To determine whether the magnitude of left ventricular contractile reserve induced by inotropic stimulation relates to short-term prognosis in patients with coronary artery disease and depressed ejection fraction.

March 1, 1975Circulation

Relation between contractile reserve and prognosis in patients with coronary artery disease and a depressed ejection fraction.

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Why the study?

Does contractile reserve assessed by inotropic stimulation predict short-term prognosis in patients with coronary artery disease and depressed ejection fraction?

Key Points

To determine whether the magnitude of left ventricular contractile reserve induced by inotropic stimulation relates to short-term prognosis in patients with coronary artery disease and depressed ejection fraction.
Evaluated 56 patients with coronary artery disease and abnormal ejection fraction (EF < 0.50) using ventriculography.
Assessed contractile reserve via postextrasystolic potentiation (PESP, n=42) or l-epinephrine infusion (n=14).
Followed patients receiving surgical treatment (n=37, mean follow-up 11.7 months) or medical treatment (n=19, mean follow-up 14.3 months).
The mean increase in EF after inotropic stimulation was significantly higher in patients with favorable outcomes from surgical or medical therapy compared to those who died or experienced progressive deterioration.
Patients achieving an inotropic EF increase of 0.10 or greater demonstrated a statistically greater probability of favorable short-term clinical outcomes than those with smaller increases.

Structured PICO

Does contractile reserve assessed by inotropic stimulation predict short-term prognosis in patients with coronary artery disease and depressed ejection fraction?

Population

56 patients with coronary artery disease and an abnormal ejection fraction (EF < 0.50). Based on severity of symptoms and technical suitability, 37 were treated surgically and 19 medically.

Intervention

Inotropic stimulation to assess contractile reserve using either postextrasystolic potentiation (PESP) (n=42) or 1-epinephrine infusion (n=14) during ventriculography.

Outcome

Short-term prognosis (good results from therapy vs death or progressive cardiac deterioration).hard clinical

Evaluation of contractile reserve via inotropic stimulation (especially PESP) helps identify patients with coronary artery disease and depressed ejection fraction who have a better short-term prognosis.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

May support short-term prognostic stratification by contractile reserve in CAD with low EF; hypothesis-generating and should not yet change practice.

Cite This Study

Cohn et al. (1975) studied this question.

synapsesocial.com/papers/6a94d739adcd4249130b18ea https://doi.org/10.1161/01.cir.51.3.414

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Implication

May support short-term prognostic stratification by contractile reserve in CAD with low EF; hypothesis-generating and should not yet change practice.

Relation between contractile reserve and prognosis in patients with coronary artery disease and a depressed ejection fraction.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Relation between contractile reserve and prognosis in patients with coronary artery disease and a depressed ejection fraction.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider