Regional wall motion analysis by dobutamine stess echocardiography to distinguish between ischemic and nonischemic dilated cardiomyopathy

American Heart Journal
C VignaF Loperfido

Abstract

To distinguish between ischemic and nonischemic dilated cardiomyopathy (DCM), we studied 43 patients with left ventricular dysfunction (15 ischemic and 28 nonischemic detected by coronary angiography) by dobutamine stress echocardiography. At rest, there were more normal segments (p<0.001) and a trend toward more akinetic segments (p, not significant) per ischemic than per nonischemic DCM patient. However, either at rest or with low-dose dobutamine, individual data largely overlapped. At peak dose, in ischemic DCM, regional contraction worsened in many normal or dys-synergic regions at rest (in the latter case after improvement with low-dose dobutamine); in contrast, in nonischemic DCM, further mild improvement was observed in a variable number of left ventricular areas. Thus with peak-dose dobutamine, more akinetic and less normal segments were present per ischemic than per nonischemic DCM patient (both, p<0.001). A value of six or more akinetic segments was 80% sensitive and 96% specific for ischemic DCM. Our data show that analysis of regional contraction by dobutamine stress echocardiography can distinguish between ischemic and nonischemic DCM.

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Citations

Jan 29, 2002·European Journal of Heart Failure·Bruno PinamontiGianfranco Sinagra
Jan 12, 2007·The International Journal of Cardiovascular Imaging·Brian J SchietingerChristopher M Kramer
May 6, 2006·Medicinski pregled·Vladimir MiloradovićAleksandar D Popović
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Jun 24, 2010·American Heart Journal·Harmony R ReynoldsBarry P Rosenzweig
Sep 12, 2007·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Margareta Scharin TängBert Andersson
Jun 5, 2007·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Ze-Zhou Song, Jing Ma
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Apr 3, 2015·Journal of Human Genetics·Suparat SrithawongWibhu Kutanan
Feb 15, 2001·Echocardiography·Cherian SebastianKrishnaswamy Chandrasekaran

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