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- Title
Abnormal contractile responses during dobutamine stress echocardiography in patients with idiopathic dilated cardiomyopathy.
- Authors
de Jong, Richard M.; Cornel, Jan H.; Crijns, Harry J.G.M.; van Veldhuisen, Dirk J.; de Jong, R M; Cornel, J H; Crijns, H J; van Veldhuisen, D J
- Abstract
<bold>Background: </bold>In chronic heart failure augmented wall stress leads to increased energy demand. Supply, however, may be reduced due to coronary vasoconstriction and endothelial dysfunction. This might lead to a mismatch between demand and supply. In the present study we further explored the effect of increased demand during dobutamine stress echocardiography.<bold>Methods and Results: </bold>Sixteen patients with idiopathic dilated cardiomyopathy (mean age 44+/-13 years, New York Heart Association class II-III, mean left ventricular ejection fraction 0.27+/-0.10) underwent dobutamine stress echocardiography (5-40 microg/min per kg bodyweight+atropine if required). Wall motion and thickening was assessed in 16 segments using a four-point scale. Eleven patients (69%) showed regions with worsening of wall motion or a biphasic response during dobutamine infusion. Of the remaining five patients one patient did not show any wall motion changes and one patient showed a partial improvement while only in three patients wall motion improvement in the whole heart was found.<bold>Conclusion: </bold>A majority of patients with idiopathic dilated cardiomyopathy showed decreased wall motion during increased demand, i.e. ischemia-like myocardial contractile responses during dobutamine stress echocardiography. These findings further support the concept that an energy mismatch between demand and supply might play a pathophysiological role in idiopathic dilated cardiomyopathy.
- Subjects
HEART failure; DOBUTAMINE; STRESS echocardiography; VASOCONSTRICTION; IDIOPATHIC dilated cardiomyopathy
- Publication
European Journal of Heart Failure, 2001, Vol 3, Issue 4, p429
- ISSN
1388-9842
- Publication type
journal article
- DOI
10.1016/S1388-9842(01)00143-X