Journal of Interventional Cardiac Electrophysiology

, Volume 23, Issue 2, pp 121–126

Presence of left ventricular contractile reserve, evaluated by means of dobutamine stress-echo test, is able to predict response to cardiac resynchronization therapy

  • Bernardino Tuccillo
  • Carmine Muto
  • Raffaele Iengo
  • Maria Accadia
  • Salvatore Rumolo
  • Micheleangelo Canciello
  • Giovanni Carreras
  • Raimondo Calvanese
  • Eduardo Celentano
  • Mario Davinelli
  • Sergio Valsecchi
  • Luigi Ascione
Article

DOI: 10.1007/s10840-008-9255-9

Cite this article as:
Tuccillo, B., Muto, C., Iengo, R. et al. J Interv Card Electrophysiol (2008) 23: 121. doi:10.1007/s10840-008-9255-9

Abstract

Introduction

We evaluated whether the dobutamine stress-echo test can select responders to cardiac resynchronization therapy (CRT). Up to 50% of patients do not respond to CRT. Lack of response may be due to a significant amount of scar or fibrotic tissue at myocardial level.

Methods and Results

We studied 42 CRT patients. After clinical and echocardiographic evaluation, all patients underwent a dobutamine stress-echo test to assess contractile reserve. Cut-off for the test was an increase of 25% of the left ventricular ejection fraction. Patients were implanted with a CRT–defibrillator and followed up at 6 months. Cut-off for CRT response was a reduction of 15% of left ventricular end-systolic volume. Twenty-five patients responded to CRT; all of them showed presence of contractile reserve. The test showed a sensitivity of 100% and a specificity of 88%.

Conclusion

Contractile reserve was a strong predictive factor of response to CRT in the studied population.

Keywords

Cardiac resynchronization therapy Dobutamine stress echocardiography Contractile reserve Dyssynchrony 

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Bernardino Tuccillo
    • 1
  • Carmine Muto
    • 1
    • 3
  • Raffaele Iengo
    • 1
  • Maria Accadia
    • 1
  • Salvatore Rumolo
    • 1
  • Micheleangelo Canciello
    • 1
  • Giovanni Carreras
    • 1
  • Raimondo Calvanese
    • 1
  • Eduardo Celentano
    • 1
  • Mario Davinelli
    • 2
  • Sergio Valsecchi
    • 2
  • Luigi Ascione
    • 1
  1. 1.Santa Maria di Loreto Mare HospitalNaplesItaly
  2. 2.Medtronic ItalyRomeItaly
  3. 3.Unità Operativa di Cardiologia, Ospedale Santa Maria di Loreto MareNaples-IItaly

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