Low-dose dobutamine stress echocardiography to assess left ventricular contractile reserve for cardiac resynchronization therapy: data from the Low-Dose Dobutamine Stress Echocardiography to Predict Cardiac Resynchronization Therapy Response (LODO-CRT) trial.
Cardiac resynchronization therapy (CRT) is an effective methodology indicated in selected heart failure patients. Identifying responders to the therapy is still challenging. Most studies report that at least 30% of the patients are nonresponders. Baseline characteristics of the Low-Dose Dobutamine Stress Echocardiography to Predict Cardiac Resynchronization Therapy Response (LODO-CRT) trial population are presented. The study investigates dobutamine stress echocardiography's role in predicting CRT response. Two hundred seventy-one CRT candidates were studied. Mean age was 67+/-10 years, 69% were male, 96% had New York Heart Association class III disease, and 39% had heart failure of ischemic etiology. Mean QRS and left ventricular ejection fraction were 146+/-24 ms and 26%+/-6%, respectively. Seventy-seven percent of participants showed contractile reserve. Left ventricular end-diastolic volume was shown to be independently associated with contractile reserve presence. In particular, more dilated ventricles are associated with a lower chance of having contractile reserve. The LODO-CRT trial enrolled a cohort of patients fulfilling criteria for CRT. Dobutamine stress echocardiography was highly feasible and safe in this population. Contractile reserve was associated with healthier ventricles.
Iacopino
Saverio
S
Sant'Anna Hospital, Catanzaro, Italy. iacopino@iol.it
Gasparini
Maurizio
M
Zanon
Francesco
F
Dicandia
Cosimo
C
Distefano
Giuseppe
G
Curnis
Antonio
A
Donati
Roberto
R
Neja
Carlo P
CP
Calvi
Valeria
V
Davinelli
Mario
M
Novelli
Vanessa
V
Muto
Carmine
C
D000368:Aged; D002304:Cardiac Pacing, Artificial; D015331:Cohort Studies; D016001:Confidence Intervals; D025401:Echocardiography, Stress; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000473:pathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009200:Myocardial Contraction; D016017:Odds Ratio; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D013318:Stroke Volume; D016277:Ventricular Function, Left