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

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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.

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Acknowledgment

We are thankful to Tiziana De Santo (Clinical Service Team, Medtronic Italy) for the statistical support.

Grants and disclosures

Mario Davinelli and Sergio Valsecchi are Medtronic Italy employees. No other conflicts of interest exist.

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Authors and Affiliations

  1. Santa Maria di Loreto Mare Hospital, Naples, Italy

    Bernardino Tuccillo, Carmine Muto, Raffaele Iengo, Maria Accadia, Salvatore Rumolo, Micheleangelo Canciello, Giovanni Carreras, Raimondo Calvanese, Eduardo Celentano & Luigi Ascione

  2. Medtronic Italy, Rome, Italy

    Mario Davinelli & Sergio Valsecchi

  3. Unità Operativa di Cardiologia, Ospedale Santa Maria di Loreto Mare, Via Marittima, 80142, Naples-I, Italy

    Carmine Muto

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  1. Bernardino Tuccillo
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  2. Carmine Muto
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  3. Raffaele Iengo
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Correspondence to Carmine Muto.

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Tuccillo, B., Muto, C., Iengo, R. et al. Presence of left ventricular contractile reserve, evaluated by means of dobutamine stress-echo test, is able to predict response to cardiac resynchronization therapy. J Interv Card Electrophysiol 23, 121–126 (2008). https://doi.org/10.1007/s10840-008-9255-9

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  • DOI: https://doi.org/10.1007/s10840-008-9255-9

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