Impaired Left Ventricular Stroke Volume Reserve During Clinical Dobutamine Stress Predicts Future Episodes of Pulmonary Edema

摘要: Objectives The purpose of this study was to determine whether dobutamine-induced abnormal stress changes in left ventricular stroke volume (LVSV) and aortic stiffness predict future pulmonary edema. Background Increased that decreases LVSV during adrenergic may serve as a marker for edema (PE). Methods We measured LVSV, ventriculovascular (pulse pressure/LVSVindex), distensibility at rest intravenous dobutamine administration using cardiovascular magnetic resonance. Personnel blinded resonance followed participants longitudinally over time identify those admitted the hospital with PE. Data 44 who had admission PE were compared data 72 similar age, sex, resting ejection fraction remained free. Results Expressed median interquartile range, without exhibited decreased stress/rest ratio (0.9 [range 0.7 1.1] vs. 1.0 0.9 1.2], respectively; p = 0.002), an increased (1.4 1.6] 0.8 1.3], ≤ 0.001); stress-induced measure (0.8 mm Hg−3 0.3 1.3 Hg−3] 1.6 1.2 3.2 Hg−3], 0.002). After accounting fraction, risk factors PE, presence ischemia, reserve still differed (p Conclusions In patients inducible ischemia testing whom one might otherwise assume favorable prognosis, failure increase or indicates subsequent