Skip Navigation

European Journal of Heart Failure 2002 4(3):269-276; doi:10.1016/S1388-9842(01)00239-2
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Jourdain, P.
Right arrow Articles by Desnos, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jourdain, P.
Right arrow Articles by Desnos, M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 2002 European Society of Cardiology

Myocardial contractile reserve under low doses of dobutamine and improvement of left ventricular ejection fraction with treatment by carvedilol

P. Jourdaina,*, F. Funcka, Y. Fullab, A. Hagegec, M. Bellorinia, N. Guillarda, J. Loireta, B. Thebaulta and M. Desnosc

a Service de Cardiologie Hôpital R. Dubos 6 avenue d’île de France, 95300 Pontoise, France
b Service de Médecine Nucléaire Hôpital Cochin Paris, France
c Service de Cardiologie Hôpital Georges Pompidou Paris, France

* Corresponding author. Tel.: +33-13075-4186; fax: +33-13075-4433


  Abstract

To examine the ability of myocardial contractile reserve (MCR) assessment to predict the improvement of left ventricular ejection fraction with treatment by carvedilol, a prospective study was undertaken in 85 patients with chronic heart failure and left ventricular ejection fraction <45%. Low dose dobutamine echocardiography (DSE), a 6-min walk test and measured brain natriuretic peptide (BNP) were assessed in all the patients. Patients were separated into two groups. Group A were patients without any myocardial reserve and group B patients with a myocardial contractile reserve defined as an increment of more than 20% of the resting left ventricular ejection fraction during dobutamine infusion. The two groups differed for percentage of ischemic cardiomyopathy (67.8 in group A vs. 29.7% in group B P=0.028), 6-min walk test performance (respectively, 343 vs. 415 meters P<0.05) and BNP plasma levels (respectively, 184.5 vs. 70.1 P<0.02) but not for left ventricular ejection fraction or NYHA class. During DSE, MCR and heart rate variation was higher in group B than in group A. At the end of the follow up, LVEF increased and NYHA class decreased in group B but not in group A. In multivariate analysis the existence of MCR could predict the improvement of LVEF with treatment by carvedilol. In our study, studying MCR could help to predict patients who will improve their LVEF with carvedilol prior to the administration of the treatment.

Key Words: Myocardial contractile reserve • Heart failure • Beta-blocker therapy

Received February 15, 2001; Revised August 29, 2001; Accepted September 12, 2001


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.