ORBi: Sénéchal Mario - Contractile reserve assessed using dobutamine echocardiography predicts left ventricular reverse remodeling after cardiac resynchronization therapy: prospective validation in patients with left ventricular dyssynchrony.

Reference : Contractile reserve assessed using dobutamine echocardiography predicts left ventricular...


	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/2268/84307

Title :	Contractile reserve assessed using dobutamine echocardiography predicts left ventricular reverse remodeling after cardiac resynchronization therapy: prospective validation in patients with left ventricular dyssynchrony.
Language :	English
Author, co-author :	Sénéchal, Mario [Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada > Department of Cardiology > > >]
	Lancellotti, Patrizio [Université de Liège - ULg > Département des sciences cliniques > Imagerie cardiaque fonctionnelle par échographie >]
	Magne, Julien [Université de Liège - ULg > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation >]
	Garceau, Patrick [Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada > Department of Cardiology > > >]
	Champagne, Jean [Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada > Department of Cardiology > > >]
	Blier, L. [Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada > Department of Cardiology > > >]
	Molin, F. [Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada > Department of Cardiology > > >]
	Philippon, F. [Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada > Department of Cardiology > > >]
	Moonen, Marie [Université de Liège - ULg > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation >]
	O'Hara, G. [Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada > Department of Cardiology > > >]
	Dubois, M. [Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada > Department of Cardiology > > >]
Publication date :	2010
Journal title :	Echocardiography
Publisher :	Future Pub Co
Volume :	27
Issue/season :	6
Pages :	668-76
Audience :	International
ISSN :	0742-2822
e-ISSN :	1540-8175
City :	Armonk
Country :	NY
Keywords :	[en] contractile reserve ; dobutamine echocardiography ; LV reverse remodeling ; cardiac resynchronization therapy ; heart failure
Abstract :	[en] Background: The presence of viable myocardium may predict response to cardiac resynchronization therapy (CRT). The aim of this study is to evaluate in patients with left ventricular (LV) dyssynchrony whether response to CRT is related to myocardial viability in the region of the pacing lead. Methods: Forty-nine consecutive patients with advanced heart failure, LV ejection fraction < 35%, QRS duration > 120 ms and intraventricular asynchronism ≥ 50 ms were included. Dobutamine stress echocardiography was performed within the week before CRT implantation. Resting echocardiography was performed 6 months after CRT implantation. Viability in the region of LV pacing lead was defined as the presence of viability in two contiguous segments. Response to CRT was defined by evidence of reverse LV remodeling (≥15% reduction in LV end-systolic volume). Results: Thirty-one patients (63%) were identified as responders at follow-up. The average of viable segments was 5.9 ± 2 in responders and 3.2 ± 3 in nonresponders (P = 0.0003). Viability in the region of the pacing lead had a sensitivity of 94%, a specificity of 67%, a positive predictive value of 83%, and a negative predictive value of 86% for the prediction of response to CRT. Conclusions: In patients with LV dyssynchrony, reverse remodeling after CRT requires viability in the region of the pacing lead. This simple method using echocardiography dobutamine for the evaluation of local viability (i.e., viability in two contiguous segments) may be useful to the clinician in choosing the best LV lead positioning.
Funders :	Fonds de la Recherche Scientifique (Communauté française de Belgique) - F.R.S.-FNRS
Target :	Researchers ; Professionals
Permalink :	http://hdl.handle.net/2268/84307
	also: http://hdl.handle.net/2268/140759
DOI :	10.1111/j.1540-8175.2009.01106.x

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