Prognostic value of dobutamine stress echocardiography in patients with normal left ventricular systolic function

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
Abdou ElhendyD Poldermans

Abstract

Patients with normal left ventricular systolic function are considered to be at a relatively low risk for cardiac events. There are scarce data regarding association of ischemia on stress imaging techniques with outcome in these patients. We sought to assess the prognostic significance of dobutamine-induced myocardial ischemia for patients with normal left ventricular systolic function. We studied 528 patients with normal baseline left ventricular systolic function who underwent high-dose dobutamine-atropine stress echocardiography and were followed up for 4.7 +/- 2.1 years for occurrence of death and hard cardiac events (cardiac death and nonfatal myocardial infarction). Ischemia (new wall-motion abnormalities) was detected in 127 patients (24%). Follow-up events were death in 69 patients (13%) and hard cardiac events in 55 patients (10%). The annual hard cardiac event rate was 5% for patients with ischemia and 1.1% for patients without. In a multivariate analysis model, ischemia was the only independent predictor of hard cardiac events (risk ratio [RR] 4.3, 95% confidence intervals [CI] 2.5-7.4). Predictors of all causes of mortality were advanced age (RR 1.08, CI 1.05-1.11), higher resting rate pressure product (RR 1.11, CI ...Continue Reading

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Citations

Mar 25, 2011·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Nowell M Fine, Patricia A Pellikka
Aug 12, 2005·Current Opinion in Cardiology·Elena BiaginiDon Poldermans
Dec 7, 2011·The International Journal of Cardiovascular Imaging·Geu-Ru HongMani A Vannan
Mar 15, 2013·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Angele A A MattosoWilson Mathias
Jan 12, 2008·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Ronald MastouriStephen G Sawada
Jun 27, 2008·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Rosa SicariUNKNOWN European Association of Echocardiography
Sep 1, 2005·Circulation·Jeane M TsutsuiThomas R Porter

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