Diagnostic and prognostic implications of left ventricular cavity obliteration response to dobutamine echocardiography

The American Journal of Cardiology
M A SecknusT Marwick

Abstract

Left ventricular (LV) cavity obliteration during dobutamine echocardiography (DE) indicates a vigorous inotropic response to stress. Such a response may suggest the absence of coronary artery disease (CAD), but a small LV cavity may also preclude recognition of wall motion abnormalities. We sought to determine the frequency, correlates, accuracy, and prognostic value of the LV cavity obliteration response in 336 consecutive patients who underwent coronary angiography within 1 year of DE. Cavity obliteration was defined by contact of the opposite walls in the apical views during DE, and ischemia by detection of a new or worsening wall motion abnormality. Sensitivity was based on comparison with coronary anatomy in 220 patients without prior revascularization. The prognostic implications of cavity obliteration were examined by follow-up of 324 patients (96%) over 23 +/- 9 months for death, myocardial infarction, and late revascularization. Cavity obliteration was present in 86 of the 336 DE studies (26%). Baseline and stress hemodynamics were not predictive of cavity obliteration, which was associated with LV hypertrophy and female gender (p <0.0001), and inversely related to LV systolic dysfunction and use of angiotensin-convert...Continue Reading

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Citations

Jul 7, 2011·The International Journal of Cardiovascular Imaging·Francesca InnocentiRiccardo Pini
Aug 15, 2000·Clinical Cardiology·B W Usher, T X O'Brien
Jun 3, 1999·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·C A HerzogC D Dick
Jul 31, 2007·The American Journal of Cardiology·Sripal BangaloreFarooq A Chaudhry
Oct 18, 2002·Journal of the American College of Cardiology·Satoshi YudaThomas H Marwick
Jan 18, 2014·International Journal of Cardiology·Jesus G MirelisRolf Gebker
Dec 2, 2006·Journal of Cardiothoracic and Vascular Anesthesia·Feroze MahmoodAndrew D Maslow

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