title: Myocardial inotropic reserve: An old twist that constitutes a reliable index in the modern era of heart failure.
abstract: Current national and international guidelines, including those of the European Society of Cardiology, recognize that the assessment of prognosis should be a part of the standard management for patients with chronic heart failure (CHF). However, these same guidelines recognize the inherent difficulty of this process. A variety of factors contribute to this difficulty, including the varying etiology, frequent co-morbidity and, perhaps most importantly, huge inter-individual variability in the disease progression and outcome. Although CHF is chronic, it is also a condition in which significant proportions of patients experience apparently 'sudden' death, which almost certainly contributes to our difficulty in assessing individual patient prognosis. A useful tool for the risk stratification of heart failure patients is dobutamine stress echocardiography (DSE), which determines the myocardial viability in ischemic cardiomyopathy and myocardial contractile reserve in idiopathic cardiomyopathy.
authors.affiliation: Cardiology Department, Heraklion University Hospital, Greece.
authors.forename: Fragkiskos
authors.initials: F
authors.lastname: Parthenakis
authors.affiliation: Cardiology Department, Heraklion University Hospital, Greece. Electronic address: smaragoudakis79@hotmail.com.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Maragkoudakis
authors.affiliation: Cardiology Department, Heraklion University Hospital, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Marketou
authors.affiliation: Cardiology Department, Heraklion University Hospital, Greece.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Patrianakos
authors.affiliation: Cardiology Department, Heraklion University Hospital, Greece.
authors.forename: Evaggelos
authors.initials: E
authors.lastname: Zacharis
authors.affiliation: Cardiology Department, Heraklion University Hospital, Greece.
authors.forename: Panos
authors.initials: P
authors.lastname: Vardas
mesh_terms: D025401:Echocardiography, Stress / Q000379:methods*; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D059039:Standard of Care
keywords: dobutamine stress echocardiography; inotropic reserve