Dobutamine-stress echocardiography in asymptomatic patients with aortic regurgitation.
BACKGROUND
Decreased contractile reserve may already be present in asymptomatic patients with aortic regurgitation and normal ejection fraction (EF), thus indicating the need for frequent and accurate assessments of the left ventricular function for the early detection of systolic dysfunction.


OBJECTIVE
To analyze if increments in EF with low dose dobutamine could predict surgery and/or death in patients with aortic regurgitation.


METHODS
Dobutamine-stress echocardiography was performed in 24 patients with aortic regurgitation in order to analyze whether EF increments at low dobutamine doses could predict the need for surgery and/or death in this group of patients.


RESULTS
Mean age was 37.8+/-16.8 years and 16 patients (66%) were male. EF increased from a mean baseline value of 62.3+/-7.9% to 71.5+/-10.5% at a dobutamine dose of 20 microg/kg/min (p<0.001). The patients were followed-up for 36.6+/-20.1 months; two patients died (one of cardiovascular death) and five underwent cardiac surgery. Baseline EF was correlated with surgery and death in the follow-up of patients.


CONCLUSIONS
Baseline EF was correlated with surgery or death in the follow-up of young patients with aortic regurgitation. However, the percentage increase in EF at low dobutamine doses did not allow us to predict events in these patients.
Barbosa
Marcia M
MM
Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brazil. marciambarbosa@terra.com.br
Freire
Claudia M V
CM
Fenelon
Lúcia M A
LM
Esteves
William A M
WA
Reis
Gilmar
G
Nunes
Maria do Carmo P
Mdo C
D000328:Adult; D001022:Aortic Valve Insufficiency / Q000175:diagnosis* / Q000503:physiopathology; D002316:Cardiotonic Agents / Q000008:administration & dosage; D002908:Chronic Disease; D004280:Dobutamine / Q000008:administration & dosage; D015150:Echocardiography, Doppler; D025401:Echocardiography, Stress / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011875:Radionuclide Angiography; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis; D016277:Ventricular Function, Left / Q000502:physiology*
D002316:Cardiotonic Agents; D004280:Dobutamine