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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

EXERCISE TESTING VS. DOBUTAMINE STRESS ECHOCARDIOGRAPHY IN ASSESSMENT OF ONE-YEAR PROGNOSIS IN PATIENTS WITH IDIOPATHIC DILATED CARDIOMYOPATHY
P. OtaÜeviŠ, Z. PopoviŠ, A. VlahoviŠ, D. BojiŠ, L. Pratali and A.N. NeÜkoviŠ
Dedinje Cardiovascular Institute, Belgrade, CNR2, Pisa, Yugoslavia, Italy

In order to assess prognostic implications of dobutamine echocardiogarphy (DSE) and exercise testing (ET) with idiopathic dilated cardiomyopathy, we have analyzed 48 consecutive patients. DSE was performed using 5, 10, 20, 30 and 40 mcg/kg/min infusions, in progressive stages lasting 5 minutes each. Dobutamine induced changes in wall motion score index (WMSI), ejection fraction (EF), end-systolic pressure/volume ratio (ESPVR) and cardiac power output (CPO) were used to test patients. Patients were subjected to exercise test in form of bicycle ergometry, whiach was performed in 25 W increments, lasting 120 seconds each, until 150 W or until maximal exercise capacity was reached. Tests were considered negative if change in WMSI│0.22, EF│5%, ESPVR│0.4, CPO│1 W, and if exercise time was >240 seconds. All patients were followed 12 months for combined end-point of cardiac death, hospitalization for congestive heart failure, and partial left ventriculectomy. Sensitivity (Sn), specificity (Sp), accuracy (ACC) and positive and negative predictive values (PPV and NPV, respectively) were calculated for each test.
Results: The study group consisted of 41 males and 7 females, aged 50 + 10 years, with 13/48 patients being NYHA III/IV class. Mean EF was 21▒8%. Results are shown in Table;
Conclusion: It appears that both ET and WMSI are good prognostic markers, since they both have reasonably good Sn and Sp. On the other hand, clinical use of other DSE derived indices, except WMSI, may be limited by their low Sp.

Drugi kongres kardiologa i angiologa Bosne i Hercegovine
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