Relevance of left ventricular contractile reserve evaluated by dobutamine echocardiography in patients with advanced chronic heart failure

Česká verze

Authors: P. Lupínek; P. Frídl; I. Málek; T. Marek; J. Kautzner
Authors place of work: Klinika kardiologie IKEM, Praha, přednosta doc. MUDr. Josef Kautzner, CSc., FESC
Published in the journal: Vnitř Lék 2005; 51(9): 950-956
Category: Původní práce

Summary

Background:
Several publications have suggested that the examination of left ventricular contractile reserve by dobutamine echocardiography may be useful in the prognostic evaluation of patients with heart failure.

Aim:
To investigate whether the change of left ventricular volumes, ejection fraction (LVEF) and Doppler Tei index after dobutamine challenge is able to predict further evolution of heart failure.

Methods:
66 heart transplant candidates (average age 51.5 ± 9.2 years; men/women 55/11, dilated cardiomyopathy/ischemic heart disease 32/34) with chronic systolic heart failure underwent dobutamine echocardiography (5 and 10 µg/kg/min each 5 min) with assessment of enddiastolic and endsystolic volumes (EDV, ESV), LVEF and Tei index. The same parameters were examined after 1 year.

Results:
Dobutamine test showed statistically significant improvement of LVEF (p = 0.004), ESV (p = 0.003) and Tei index (p < 0.001). Changes of LVEF and Tei index with dobutamine had no relation to the changes of these parameters after 1 year. Only in patients with ischemic heart disease there was a significant correlation between EDV and ESV changes during the dobutamine test and their changes after 1 year (r = 0.61, p = 0.016; r = 0.57, p = 0,027).

Conclusions:
EDV and ESV changes during dobutamine test can predict to a certain degree left ventricular remodelling within 1 year in patients with advanced heart failure due to ischemic heart disease. Changes of LVEF and Tei index do not have such a predictive value.

Key words:
heart failure -⁠ heart transplantation -⁠ dobutamine echocardiography -⁠ left ventricular remodelling -⁠ contractile reserve

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