Effects of dobutamine on left ventricular shape and geometry: an easy way to detect the functional status of chronic heart failure in patients with dilated cardiomyopathy.
OBJECTIVE
Changes in left ventricular geometry and shape are prominent characteristics of cardiomyopathy. The aim of this study was to investigate left ventricular geometry and shape changes after inotropic stimulation in patients with chronic nonischemic dilated cardiomyopathy.


METHODS
A low infusion rate echocardiography-dobutamine study was performed in 35 consecutive patients (age: 50 +/- 8 years) with known dilated cardiomyopathy. Peak exercise oxygen consumption was measured the day before. Overall left ventricular chamber shape was assessed by using the long-/minor-axis dimension ratio obtained at end-diastole and end-systole.


RESULTS
After dobutamine infusion, in the entire study group an increase in systolic long-/minor-axis dimension ratio (0.11 +/- 0.13 mm, P <.001) was observed. The study population was further divided according to whether peak exercise oxygen consumption was less (group I) or more (group II) than 14 mL/kg/min. Although at baseline systolic long-/minor-axis dimension ratio was similar between groups, after dobutamine infusion it was higher in group II (1.51 +/- 0.19) than in group I (1.31 +/- 0.2, P <.01) indicating the abnormal response of systolic sphericity index to inotropic stimulation in patients with advanced functional class heart failure.


CONCLUSIONS
The response of systolic sphericity index to dobutamine infusion might be an alternative index of the functional status of the failing heart in patients with nonischemic dilated cardiomyopathy.
Paraskevaidis
Ioannis A
IA
Onassis Cardiac Surgery Center, 2nd Department of Cardiology, Athens, Greece. elbee@ath.forthnet.gr
Dodouras
Thomas
T
Adamopoulos
Stamatis
S
Kremastinos
Dimitrios Th
DT
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000473:pathology / Q000503:physiopathology*; D002908:Chronic Disease; D025401:Echocardiography, Stress; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010101:Oxygen Consumption; D012044:Regression Analysis; D016277:Ventricular Function, Left