Praxis Medica (Jan 2014)

Differences in the clinical characteristics of patients with dilated cardiomyopathy, depending on the presence of preserved left ventricular contractile reserve assessed by exercise stress-echo-cardiography

  • Perić V.,
  • Jovanović A.,
  • Rašić D.,
  • Todorović M.,
  • Lazić S.,
  • Đikić D.,
  • Novaković T.,
  • Šipić M.,
  • Aleksovski D.,
  • Dejanović B.,
  • Sovrlić B.

DOI
https://doi.org/10.5937/pramed1402009P
Journal volume & issue
Vol. 43, no. 2
pp. 9 – 13

Abstract

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Preserved left ventricular contractile reserve means the ability of poorly contractile myocardial segments to improve their contractility under the influence of different inotropic stimulus. To determine the differences in the clinical features of patients with dilated cardiomyopathy, depending on the preserved left ventricular contractile reserve. The study included 55 consecutive patients with idiopathic dilated cardiomyopathy. All patients included in the study was performed exercise stress echocardiography test according to standard protocol. The presence of preserved contractile reserve was determined using the change in left ventricular ejection fraction. The mean age of patients was 54.98 ± 9.84 years, 49 (89.1%) were males. Based on the changes in left ventricular ejection fraction as a criterion of left ventricular contractile reserve, preserved contractile reserve had 25 patients (45.5%). Patients without preserved left ventricular contractile reserve significantly more frequent have a history of hypertension (46.7 vs. 20.0%, p = 0.038). No significant differences in the prevalence of other risk factors. Patients with preserved left ventricular contractile reserve have a smaller end-systolic left ventricular dimension (49.64 ± 7.26 vs. 55.27 ± 8:36 mm, p = 0.011), smaller end-diastolic (77.35 ± 26.41 vs. 94.59 ± 34.97 ml / m2, p = 0.005) and end-systolic left ventricular volume index (59.31 ± 26.05 vs. 78.62 ± 34.42 ml/m2, p = 0.002), higher left ventricular ejection fraction (25.48 ± 8.32 vs. 18.33 ± 6.49%, p=0.002), and lower wall motion score index (2.23 ± 0.27 vs. 2.48 ± 0.27, p=0.002). Patients with preserved left ventricular contractile reserve less frequently represented with a his­tory of hypertension and significantly less morphologically and functionally damaged left ventricle.

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