[Recent advances in the prognostic evaluation of non-ischemic dilated cardiomyopathy].
Heart failure is a progressive syndrome. The rate of deterioration is highly variable and depends on several factors such as the nature and the causes of the overload, and the age of the patient. In general, following a long period of asymptomatic left ventricular (LU) dysfunction, the progression of the disease is rapid once symptoms ensue. Stress echocardiography may play a role both in the early and advanced stages of the disease. In the initial stages a reduced inotropic reserve can unmask initial damage. At advanced stages, stress echocardiography can identify a subgroup of patients at a better outcome despite a similar rest LV function. Protocols and stressors are the conventional ones also applied to patients with known or suspected coronary artery disease. Dipyridamole or dobutamine are able, with an excellent safety profile, to induce a contractile reserve, but the vasodilator stress has the advantage to assess coronary flow reserve, linking the information on function to perfusion. A wide spectrum of echocardiographic parameters is available to the clinical cardiologist assessing the risk of the individual patient. Rest and stress echocardiography are the ideal tool to be applied to this class of patients with dilated cardiomyopathy due to its low cost, widespread availability, lack of ionising radiation and repeatability.
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D000318:Adrenergic beta-Agonists; D002303:Cardiac Output, Low / Q000503:physiopathology; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003326:Coronary Circulation / Q000187:drug effects; D004176:Dipyridamole; D004280:Dobutamine; D004359:Drug Therapy, Combination; D025401:Echocardiography, Stress; D015633:Extravascular Lung Water / Q000000981:diagnostic imaging; D006801:Humans; D009200:Myocardial Contraction / Q000187:drug effects; D011237:Predictive Value of Tests; D011379:Prognosis; D013318:Stroke Volume / Q000187:drug effects; D014665:Vasodilator Agents; D016276:Ventricular Function / Q000187:drug effects
D000318:Adrenergic beta-Agonists; D014665:Vasodilator Agents; D004280:Dobutamine; D004176:Dipyridamole