کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2948745 1577278 2011 10 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Impaired Left Ventricular Stroke Volume Reserve During Clinical Dobutamine Stress Predicts Future Episodes of Pulmonary Edema
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Impaired Left Ventricular Stroke Volume Reserve During Clinical Dobutamine Stress Predicts Future Episodes of Pulmonary Edema
چکیده انگلیسی

ObjectivesThe purpose of this study was to determine whether dobutamine-induced abnormal stress changes in left ventricular stroke volume (LVSV) and aortic stiffness predict future pulmonary edema.BackgroundIncreased aortic stiffness that decreases LVSV during adrenergic stress may serve as a marker for future pulmonary edema (PE).MethodsWe measured LVSV, ventriculovascular stiffness (pulse pressure/LVSVindex), and aortic distensibility at rest and during intravenous dobutamine administration using cardiovascular magnetic resonance. Personnel blinded to dobutamine cardiovascular magnetic resonance followed participants longitudinally over time to identify those admitted to the hospital with PE. Data for 44 participants who had a hospital admission for PE were compared with data for 72 participants of similar age, sex, and resting left ventricular ejection fraction who remained PE free.ResultsExpressed as median and interquartile range, participants with and without PE exhibited a decreased stress/rest LVSV ratio (0.9 [range 0.7 to 1.1] vs. 1.0 [range 0.9 to 1.2], respectively; p = 0.002), an increased ventriculovascular stiffness stress/rest ratio (1.4 [range 1.0 to 1.6] vs. 1.0 [range 0.8 to 1.3], respectively; p ≤ 0.001); and a decreased stress-induced measure of aortic distensibility (0.8 mm Hg−3 [range 0.3 to 1.3 mm Hg−3] vs. 1.6 mm Hg−3 [range 1.2 to 3.2 mm Hg−3], respectively; p = 0.002). After accounting for age, sex, left ventricular ejection fraction, risk factors for PE, and the presence of dobutamine-induced ischemia, LVSV reserve and the stress/rest ventriculovascular stiffness ratio still differed (p < 0.008 for both) in those with and without PE.ConclusionsIn patients without inducible ischemia during dobutamine stress testing in whom one might otherwise assume a favorable prognosis, the failure to increase LVSV or an increase in ventriculovascular stiffness indicates patients at risk of subsequent PE.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the American College of Cardiology - Volume 57, Issue 7, 15 February 2011, Pages 839–848
نویسندگان
, , , , , , ,