Key result
An abnormal end-diastolic volume response during dobutamine stress echocardiography independently predicted spontaneous cardiac events.
Why the study?
Does an abnormal left ventricular volume response during dobutamine stress echocardiography predict spontaneous cardiac events?
Cohort (n=136)
Does an abnormal left ventricular volume response during dobutamine stress echocardiography predict spontaneous cardiac events?
An abnormal end-diastolic volume response during dobutamine stress echocardiography independently predicts spontaneous cardiac events, suggesting its utility for prognostic stratification.
Answers are grounded in this paper and cite their sources.
May support risk stratification during dobutamine stress echocardiography; leaves open prospective validation of incremental clinical utility.
AIMS: An abnormal left ventricular volume response during dobutamine echocardiography identified patients with severe coronary artery disease. The aim of the study was to assess the prognostic value of left ventricular volume changes during dobutamine stress echocardiography in 136 patients. METHODS AND RESULTS: Endpoints were defined as spontaneous cardiac events at follow-up. Left ventricular end-diastolic and end-systolic volume changes (abnormal response: < 10% and < 20% decrease, respectively) were compared with other clinical and stress test variables. During 18 +/- 7 months of follow-up, 31 cardiac events occurred: 12 hard events (cardiac death [n = 6], myocardial infarction [n = 6]) and 19 soft events (unstable angina [n = 16], congestive heart failure [n = 3]). End-diastolic volume response (P = 0.006), diabetes (P = 0.008), inducible wall motion abnormalities (P = 0.024), end-systolic volume response (P = 0.039) and inducible angina (P = 0.038) were related to a greater likelihood of cardiac events. The Cox regression analysis revealed end-diastolic volume response (odds ratio: 3.0; CI 1.44-6.32) and diabetes (odds ratio: 2.7; CI 1.28-5.69) to be independent predictors of spontaneous cardiac events. Diabetes (odds ratio: 4.0; CI 1.26-12.80) and < 40% baseline ejection fraction (odds ratio: 2.21; CI1.14-4.29) were independent predictors of hard events. CONCLUSION: An abnormal end-diastolic volume response during dobutamine stress echocardiography identifies patients with an unfavourable outcome; they should be considered for more accurate prognostic stratification.
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Coletta et al. (1997) conducted a cohort in Coronary artery disease (n=136). Abnormal end-diastolic volume response vs. Normal end-diastolic volume response was evaluated on Spontaneous cardiac events (OR 3.0, 95% CI 1.44-6.32, p=0.006). An abnormal end-diastolic volume response during dobutamine stress echocardiography independently predicted spontaneous cardiac events.
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