title: Prognostic significance of submaximal negative dobutamine stress echocardiography: a 3-year follow-up study.
abstract: BACKGROUND
  To estimate the prognostic value of submaximal negative dobutamine stress echocardiography (NDSE) on major cardiac events.
  
  
  RESULTS
  Patients with NDSE were analyzed in 2 cohorts based on predicted maximal heart rate (PMHR) (< 85% or > or = 85% PMHR) and were assessed for major adverse cardiac events over 3 years. Of 756 patients with NDSE, 415 achieved > or = 85% PMHR. Both groups had comparable ejection fractions (EF) > 50% (80.6% vs. 81.9%, p = 0.66). The NsubDSE group had higher rates of atrioventricular nodal blocker use (58.7% vs. 39.9%, p < 0.0001), and diabetes (38.7% vs. 27.6%, p = 0.001). Kaplan-Meier survival analysis showed no differences in freedom from cardiac death (98% vs. 98%, p = 0.88), nonfatal myocardial infarction (94% vs. 94%, p = 0.85), or combined major cardiac events (81% vs. 78%, p = 0.24). Diabetes and preserved ejection fraction were predictive of cardiac events in a multi-variate analysis (p = 0.005).
  
  
  CONCLUSIONS
  In our study, NsubDSE carried a favorable prognosis. Diabetics were more likely to have an NsubDSE and suffer from a cardiac event despite a preserved ejection fraction. Hence further evaluation for coronary artery disease in this high risk cohort should be pursued.
authors.affiliation: Heart and Vascular Institute, Henry Ford Hospital, Heart and Vascular Institute, K-14, Detroit, MI 48202, USA.
authors.forename: Salil J
authors.initials: SJ
authors.lastname: Patel
authors.forename: Ajay
authors.initials: A
authors.lastname: Srivastava
authors.forename: Natesh
authors.initials: N
authors.lastname: Lingam
authors.forename: Gordon
authors.initials: G
authors.lastname: Jacobsen
authors.forename: Karthik
authors.initials: K
authors.lastname: Ananthasubramaniam
mesh_terms: D002316:Cardiotonic Agents; D004280:Dobutamine; D025401:Echocardiography, Stress; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D015996:Survival Rate
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine