Wall motion abnormalities with low-dose dobutamine predict a high risk of cardiac death in medically treated patients with ischemic cardiomyopathy
dc.contributor.author | Maskoun, Waddah | |
dc.contributor.author | Mustafa, Nowwar | |
dc.contributor.author | Mahenthiran, Jothiharan | |
dc.contributor.author | Gradus‐Pizlo, Irmina | |
dc.contributor.author | Kamalesh, Masoor | |
dc.contributor.author | Feigenbaum, Harvey | |
dc.contributor.author | Sawada, Stephen G. | |
dc.contributor.department | Medicine, School of Medicine | en_US |
dc.date.accessioned | 2019-09-30T14:46:03Z | |
dc.date.available | 2019-09-30T14:46:03Z | |
dc.date.issued | 2009-07 | |
dc.description.abstract | BACKGROUND: Severe and extensive coronary artery disease is the underlying cause of stress-induced wall motion abnormalities (SWMA) with low-dose (10 microg/kg/min) dobutamine suggesting that these abnormalities may identify those with poor outcome. HYPOTHESIS: We assessed the prognostic value of low-dose SWMA in medically treated patients with ischemic cardiomyopathy. METHODS: Low- and peak-dose dobutamine echocardiography was performed in 235 patients with ischemic cardiomyopathy (ejection fraction 31% +/- 8%) who were treated with medical therapy. The survival of patients with low-dose SWMA (n = 33) was compared with the survival of patients without ischemia (n = 85) and those with peak-dose SWMA (n = 117). RESULTS: There were 123 cardiac deaths (52%) during follow-up of 4.1 +/- 3.3 years. Multivariate predictors of cardiac death were age (p = 0.002, hazard ratio [HR]: 1.03), diabetes (p = 0.028, HR: 1.54), New York Heart Association (NYHA) class III, IV heart failure (p = 0.001, HR: 1.94), the presence of peak dose SWMA (p < 0.001, HR: 2.59), and low-dose SWMA (p = 0.005, HR: 2.28). Survival of patients without ischemia was significantly better than those with peak-dose SWMA (p < 0.0001) and those with low-dose SWMA (p = 0.001). The survival of patients with low-dose SWMA was the same as those with peak-dose SWMA (p = 0.89). CONCLUSIONS: Low-dose SWMA is an independent predictor of cardiac mortality in medically treated patients with ischemic cardiomyopathy. Patients with low-dose SWMA are at equivalent risk to those with peak-dose SWMA. | en_US |
dc.identifier.citation | Maskoun, W., Mustafa, N., Mahenthiran, J., Gradus-Pizlo, I., Kamalesh, M., Feigenbaum, H., & Sawada, S. G. (2009). Wall motion abnormalities with low-dose dobutamine predict a high risk of cardiac death in medically treated patients with ischemic cardiomyopathy. Clinical cardiology, 32(7), 403–409. doi:10.1002/clc.20558 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/20991 | |
dc.language.iso | en_US | en_US |
dc.publisher | Wiley | en_US |
dc.relation.isversionof | 10.1002/clc.20558 | en_US |
dc.relation.journal | Clinical cardiology | en_US |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.source | PMC | en_US |
dc.subject | Cardiomyopathies | en_US |
dc.subject | Dobutamine | en_US |
dc.subject | Myocardial Ischemia | en_US |
dc.subject | Ventricular Dysfunction, Left | en_US |
dc.title | Wall motion abnormalities with low-dose dobutamine predict a high risk of cardiac death in medically treated patients with ischemic cardiomyopathy | en_US |
dc.type | Article | en_US |