ORBi: Sénéchal Marie - Usefulness and limitation of dobutamine stress echocardiography to predict acute response to cardiac resynchronization therapy.

Reference : Usefulness and limitation of dobutamine stress echocardiography to predict acute respons...


	Document type :	Scientific journals : Article
	Discipline(s) :	Human health sciences : Cardiovascular & respiratory systems Human health sciences : General & internal medicine
	To cite this reference:	http://hdl.handle.net/2268/61849

Title :	Usefulness and limitation of dobutamine stress echocardiography to predict acute response to cardiac resynchronization therapy.
Language :	English
Author, co-author :	Sénéchal, Marie [Hôpital Laval, Québec, Canada. > Department of Cardiology, Institut de Cardiologie de Québec > > >]
	Lancellotti, Patrizio [Université de Liège - ULg > > Cardiologie >]
	Garceau, P. [> >]
	Champagne, J. [> >]
	Dubois, M. [> >]
	Magne, Julien [Université de Liège - ULg > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation >]
	Blier, L. [> >]
	Molin, F. [> >]
	Philippon, F. [> >]
	Dumesnil, J. G. [> >]
	Pierard, Luc [Université de Liège - ULg > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation >]
	O'Hara, G. [> >]
Publication date :	2010
Journal title :	Echocardiography
Publisher :	Future Pub Co
Volume :	27
Issue/season :	1
Pages :	50-57
Peer reviewed :	Yes (verified by ORBi)
Audience :	International
ISSN :	0742-2822
e-ISSN :	1540-8175
City :	Armonk
Country :	NY
Abstract :	[en] Background: It has been hypothesized that a long-term response to cardiac resynchronization therapy (CRT) could correlate with myocardial viability in patients with left ventricular (LV) dysfunction. Contractile reserve and viability in the region of the pacing lead have not been investigated in regard to acute response after CRT. Methods: Fifty-one consecutive patients with advanced heart failure, LV ejection fraction ≤ 35%, QRS duration > 120 ms, and intraventricular asynchronism ≥ 50 ms were prospectively included. The week before CRT implantation, the presence of viability was evaluated using dobutamine stress echocardiography. Acute responders were defined as a ≥15% increase in LV stroke volume. Results: The average of viable segments was 5.8 ± 1.9 in responders and 3.9 ± 3 in nonresponders (P = 0.03). Viability in the region of the pacing lead had an excellent sensitivity (96%), but a low specificity (56%) to predict acute response to CRT. Mitral regurgitation (MR) was reduced in 21 patients (84%) with acute response. The presence of MR was a poor predictor of response (sensibility 93% and specificity 17%). However, combining the presence of MR and viability in the region of the pacing lead yields a sensibility (89%) and a specificity (70%) to predict acute response to CRT. Conclusion: Myocardial viability is an important factor influencing acute hemodynamic response to CRT. In acute responders, significant MR reduction is frequent. The combined presence of MR and viability in the region of the pacing lead predicts acute response to CRT with the best accuracy.
Target :	Researchers ; Professionals
Permalink :	http://hdl.handle.net/2268/61849
	also: http://hdl.handle.net/2268/140755
DOI :	10.1111/j.1540-8175.2009.00962.x

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