Ultrasonic tissue characterization can predict beta-blocker efficacy in dilated cardiomyopathy.
The aim was to determine if the combination of cyclic variation of myocardial integrated backscatter (variation IB) and left ventricular mass measurements can predict the efficacy of beta-blocker treatment in dilated cardiomyopathy. In 32 patients, left ventricular mass and variation IB were measured at baseline and during 6 microg/kg/min dobutamine infusion before the initiation of beta-blocker therapy. Variation IB was measured at left and right ventricular halves in the ventricular septum. The baseline left ventricular mass index and transseptal variation IB gradient during dobutamine were significantly greater in the effective group (1.16 +/- 0.18 g/mL and 1.8 +/- 0.6 dB) than in the ineffective group (0.94 +/- 0.28 g/mL, p = 0.032 and 0.4 +/- 0.6 dB, p < 0.005). When both baseline left ventricular mass index > or = 1.05 g/mL and transseptal variation IB gradient during dobutamine > or = 1.5 dB were defined as predictive criteria for the effective group, the sensitivity was 78% and the specificity was 86%. Analysis of transseptal variation IB during dobutamine may provide useful information predicting the efficacy of beta-blocker therapy in dilated cardiomyopathy.
Kondo
I
I
The Second Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan.
Mizushige
K
K
Nozaki
S
S
Iwado
Y
Y
Hirao
K
K
Senda
S
S
Kohno
M
M
Matsuo
H
H
D019797:3-Iodobenzylguanidine; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D002227:Carbazoles / Q000627:therapeutic use*; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D000077261:Carvedilol; D016022:Case-Control Studies; D004280:Dobutamine; D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D011412:Propanolamines / Q000627:therapeutic use*; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D007457:Iodine Radioisotopes; D011412:Propanolamines; D000077261:Carvedilol; D019797:3-Iodobenzylguanidine; D004280:Dobutamine