title: Myocardial blood volume reserve by intravenous contrast echocardiography predicts improvement in left ventricular function in patients with nonischemic dilated cardiomyopathy.
abstract: Impaired myocardial perfusion has been shown in nonischemic dilated cardiomyopathy (DCM). Intravenous myocardial contrast echocardiography (MCE) has been introduced to examine myocardial blood volume (MBV) noninvasively. This study was designed to evaluate if MBV reserve assessed by intravenous MCE with adenosine triphosphate (ATP) can predict efficacy of optimal medical therapy in patients with DCM.
  
  
  
  Fifteen DCM patients and 8 control subjects underwent conventional echocardiography and intravenous MCE. We obtained the change in peak contrast integrated backscatter intensity (∆PI) by ATP on the left ventricular (LV) anteroseptal myocardium. After 3 months of optimal medical therapy in DCM patients, we reperformed conventional echocardiography. A good responder to therapy was defined as a decrease in LVDd >5 mm to final LVDd <55 mm and increase in LVEF >20 % to final LVEF >45 %. In DCM patients, ∆PI was lower compared to controls (p < 0.001). Good responders to therapy (n = 6) had higher ∆PI than poor responders (n = 9) (p < 0.05).
  
  
  
  The present study demonstrates that the response to the medical therapy in DCM is predicted by the assessment of dilator reserve in MBV. Intravenous MCE with ATP may provide useful information to evaluate MBV reserve.
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Miyata-Fukuoka
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. hikawai@hbhc.jp.|Department of Cardiology, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himeji, Hyogo, 670-0981, Japan. hikawai@hbhc.jp.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kawai
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Iseki
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamanaka
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ueda
authors.affiliation: Department of Cardiology, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himeji, Hyogo, 670-0981, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yokoyama
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Ken-Ichi
authors.initials: KI
authors.lastname: Hirata
mesh_terms: D001810:Blood Volume; D002311:Cardiomyopathy, Dilated; D016022:Case-Control Studies; D004452:Echocardiography; D006801:Humans; D009206:Myocardium; D018487:Ventricular Dysfunction, Left; D016277:Ventricular Function, Left
keywords: Efficacy of medical therapy; Intravenous myocardial contrast echocardiography; Myocardial blood volume reserve; Nonischemic dilated cardiomyopathy