Abstract 17730: Dobutamine Stress Echocardiography for Predicting Lv Reverse-remodeling in Idiopathic Dilated Cardiomyopathy
Introduction: The identification of contractile reserve during pharmacologic stress echocardiography may be helpful for predicting contractility recovery in idiopathic dilated cardiomyopathy (DCM). The purpose of the present study was to assess for prediction of reversible LV systolic function in patients with idiopathic DCM
Methods: We prospectively included hospitalized patients with newly diagnosis of DCM (< 40% EF and enlarged LV chamber size) from March 2012 to May. 2014. We exclude patients with AF, LBBB, significant CAD, previous beta blocker treatment, high basal heart rate >100 bpm/min by ECG and uncontrolled hypertension. Forty-five patients with DCM underwent baseline echocardiography and stress echocardiography. The dobutamine infusion was terminated at the maximal dose (40μg/kg/min) or if the maximal heart rate was achieved. Contractile reserve of LV was defined as an increase of LV ejection fraction ≥4 units during Dobutamine infusion. LV reverse remodeling (RR) was defined as an 1) increase of LV ejection-fraction≥10 units or LVEF > 40% with a 2) decreased indexed-LV end-diastolic diameter(i-LVEDD) ≥10% or i-LVEDD<33mm/m2 at 6 month follow-up echocardiography.
Results: Thirty eight patients (male 47.4%, aged 63.2 ± 12.9 years) with underwent 6 month follow-up echocardiography were included. Twenty two patients (57.9%) had the contractile reserve of LV (CR +) in Dobutamine stress test. There is no significant difference in age, NYHA class, LVEDD, BNP and LVEF between CR + and CR -. At 6 month follow-up echocardiography, fourteen patients had the LV reverse remodeling (LVRR +). During 28 ± 14.0 follow-up month, 5-death and 11-admission d/t heart failure were occured, but no any event was observed in LVRR + group. In multivariate analysis of LVRR, only contractile reserve(+) (OR:6.454, 95% CI:1.078~38.651, p=0.041) was significant predictor of LVRR
Conclusions: Contractile reserve in Dobutamine Stress echocardiography was useful to predict LV reverse-remodeling in idiopathic dilated cardiomyopathy. Large number of study patient will be needed.
Author Disclosures: J. Son: None. B. Yoo: None. J. Lee: None. Y. Youn: None. M. Ahn: None. S. Ahn: None. J. Kim: None. S. Lee: None. J. Yoon: None.
- © 2016 by American Heart Association, Inc.