Clinical investigation
Regional wall motion analysis by dobutamine stress echocardiography to distinguish between ischemic and nonischemic dilated cardiomyopathy

https://doi.org/10.1016/S0002-8703(96)90534-7Get rights and content

Abstract

To distinguish between ischemic and nonischemic dilated cardiomyopathy (DCM), we studied 43 patients with left ventricular dysfunction (15 ischemic and 28 nonischemic detected by coronary angiography) by dobutamine stress echocardiography. At rest, there were more normal segments (p < 0.001) and a trend toward more akinetic segments (p, not significant) per ischemic than per nonischemic DCM patient. However, either at rest or with low-dose dobutamine, individual data largely overlapped. At peak dose, in ischemic DCM, regional contraction worsened in many normal or dyssynergic regions at rest (in the latter case after improvement with low-dose dobutamine); in contrast, in nonischemic DCM, further mild improvement was observed in a variable number of left ventricular areas. Thus with peak-dose dobutamine, more akinetic and less normal segments were present per ischemic than per nonischemic DCM patient (both, p < 0.001). A value of six or more akinetic segments was 80% sensitive and 96% specific for ischemic DCM. Our data show that analysis of regional contraction by dobutamine stress echocardiography can distinguish between ischemic and nonischemic DCM.

References (34)

Cited by (45)

  • Influence of Age, Hypertension, and Diabetes on Cardiac Reserve in a Rat Model

    2007, Journal of the American Society of Echocardiography
    Citation Excerpt :

    However, depressed catecholamine responsiveness and cardiac performance in streptozotocin-induced diabetic swine is caused by disturbed postreceptor signaling (seen as an increase in the Gi:Gs protein ratio) and not by down-regulation of β-adrenoceptor density.19 Low-dose DSE has been shown to be able to discriminate between ischemic and nonischemic cardiomyopathy,2 and to predict clinical outcome in patients with both idiopathic dilated cardiomyopathy and ischemia.3,20 Further, it has recently been demonstrated that DSE could predict LV dilatation and provide prognostic information in patients with acute myocardial infarction.21

  • Late gadolinium-enhanced cardiovascular magnetic resonance identifies patients with standardized definition of ischemic cardiomyopathy: A single centre experience

    2007, International Journal of Cardiology
    Citation Excerpt :

    Absence of subendocardial LGE differentiated the great majority of patients whose behaviour would have indicated them as non-IC from a prognostic viewpoint (LV systolic dysfunction with no coronary disease, or disease in only one vessel without affecting the main coronary artery or the proximal segment of the anterior descending coronary artery) [5,6]. Other noninvasive methods have been used to distinguish among ischemic and idiopathic cardiomyopathy, including echocardiography [15–20], radionuclide ventriculography [21,22], stress myocardial perfusion imaging [23–26], positron emission tomography [27,28] and electron beam computer tomography [29]. The success of these different approaches to distinguish between both etiologies of cardiomyopathy has been variable.

View all citing articles on Scopus
View full text