title: Presence of left ventricular contractile reserve, evaluated by means of dobutamine stress-echo test, is able to predict response to cardiac resynchronization therapy.
abstract: BACKGROUND
  We evaluated whether the dobutamine stress-echo test can select responders to cardiac resynchronization therapy (CRT). Up to 50% of patients do not respond to CRT. Lack of response may be due to a significant amount of scar or fibrotic tissue at myocardial level.
  
  
  RESULTS
  We studied 42 CRT patients. After clinical and echocardiographic evaluation, all patients underwent a dobutamine stress-echo test to assess contractile reserve. Cut-off for the test was an increase of 25% of the left ventricular ejection fraction. Patients were implanted with a CRT-defibrillator and followed up at 6 months. Cut-off for CRT response was a reduction of 15% of left ventricular end-systolic volume. Twenty-five patients responded to CRT; all of them showed presence of contractile reserve. The test showed a sensitivity of 100% and a specificity of 88%.
  
  
  CONCLUSIONS
  Contractile reserve was a strong predictive factor of response to CRT in the studied population.
authors.affiliation: Santa Maria di Loreto Mare Hospital, Naples, Italy.
authors.forename: Bernardino
authors.initials: B
authors.lastname: Tuccillo
authors.forename: Carmine
authors.initials: C
authors.lastname: Muto
authors.forename: Raffaele
authors.initials: R
authors.lastname: Iengo
authors.forename: Maria
authors.initials: M
authors.lastname: Accadia
authors.forename: Salvatore
authors.initials: S
authors.lastname: Rumolo
authors.forename: Micheleangelo
authors.initials: M
authors.lastname: Canciello
authors.forename: Giovanni
authors.initials: G
authors.lastname: Carreras
authors.forename: Raimondo
authors.initials: R
authors.lastname: Calvanese
authors.forename: Eduardo
authors.initials: E
authors.lastname: Celentano
authors.forename: Mario
authors.initials: M
authors.lastname: Davinelli
authors.forename: Sergio
authors.initials: S
authors.lastname: Valsecchi
authors.forename: Luigi
authors.initials: L
authors.lastname: Ascione
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial; D002316:Cardiotonic Agents; D016009:Chi-Square Distribution; D004280:Dobutamine; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine