Dobutamine-induced augmentation of left ventricular ejection fraction predicts survival of heart failure patients with severe non-ischaemic cardiomyopathy

• Published in: European heart journal 2001-05, Vol.22 (10), p.849-856
• Main Authors: Ramahi, T.M, Longo, M.D, Cadariu, A.R, Rohlfs, K, Slade, M, Carolan, S, Vallejo, E, Wackers, F.J.Th
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cardiology. Vascular system; cardiomyopathy; Cardiomyopathy, Dilated - diagnostic imaging; Cardiomyopathy, Dilated - mortality; Cardiomyopathy, Dilated - physiopathology; Dobutamine; Female; Heart; Heart failure; Heart Failure - diagnostic imaging; Heart Failure - mortality; Heart Failure - physiopathology; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; inotropic reserve; Male; Medical sciences; Middle Aged; Predictive Value of Tests; Prognosis; Radionuclide Ventriculography; Stroke Volume - drug effects; Stroke Volume - physiology; Survival Rate; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - mortality; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left - drug effects; Ventricular Function, Left - physiology
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1053/euhj.2001.2654

Aims The prognosis of patients with severe non-ischaemic dilated cardiomyopathy is variable. The predictive value of currently utilized tests is suboptimal. The purpose of this study was to determine the prognostic value of dobutamineinduced augmentation of left ventricular ejection fraction in patients with non-ischaemic dilated cardiomyopathy. Methods and Results Sixty-two patients with left ventricular ejection fraction ≤0·30 underwent exercise testing with gas exchange analysis and assessment of left ventricular ejection fraction at rest and after a 10-min intravenous infusion of dobutamine at 10μg.kg−1min−1, using equilibrium radionuclide ventriculography. Age was 48±11 years, 32% females, functional class 2·6±0·6, resting left ventricular ejection fraction 0·20±0·06, and peak exercise oxygen consumption (mVO2) 19±6ml.kg−1min−1. Mean dobutamine-induced augmentation of left ventricular ejection fraction (ΔLVEF) was 0·09±0·06 (median 0·08, range −0·03 to 0·26). Follow-up was 25±15 months during which there were 12 deaths and five transplantations. Patients were divided into two groups based on median ΔLVEF. The transplant-free survival was better in the group with higher ΔLVEF (94% vs 64%, P