https://repositorio.ufba.br/handle/ri/6193
Tipo: | Artigo de Periódico |
Título: | Baseline Echocardiographic Predictors of Dynamic Intraventricular Obstruction of the Left Ventricle during Dobutamine Stress Echocardiogram |
Título(s) alternativo(s): | Echocardiography |
Autor(es): | Câmara, Edmundo José Nassri Oliveira, Maristela Magnavita Ribeiro, Fábio Maia |
Autor(es): | Câmara, Edmundo José Nassri Oliveira, Maristela Magnavita Ribeiro, Fábio Maia |
Abstract: | Intraventricular obstruction (IVO) during dobutamine stress echocardiogram (DSE) may be associated with or reproduce symptoms. Predictors of IVO are not well established. Methods:149 patients were studied at rest and during DSE. The normal range of the left ventricular outflow tract (LVOT) velocities was investigated in 68 healthy patients. Results: 19 patients (13%) developed IVO (peak LVOT velocity > 271 cm/sec). A significant linear correlation was observed between peak LVOT velocity during DSE and the following rest parameters: LV end-diastolic dimension (r=−0.20,P = 0.018), LV end-systolic dimension (r = − 0.27, P = 0.001), relative wall thickness (r = 0.23, P = 0.006), shortening fraction (r = 0.24, P = 0.004), LVOT diameter (r = − 0.20, P = 0.023) and LVOT velocity (r = 0.29, P < 0.0001). Only relative wall thickness (P = 0.012) and LVOT diameter (P = 0.027) were independent predictors of IVO. As a dichotomous variable, a relative wall thickness ≥0.44 was the only independent predictor of IVO (OR 5.7, 95% CI 1.6–20, P = 0.006), with sensitivity,specificity, negative predictive value, and positive predictive value of 77%, 62%, 95%, and 21%,respectively, and global accuracy of 63% (area under the ROC curve = 0.7). IVO was significantly associated with general cardiovascular symptoms (P = 0.0006) and with chest pain (P = 0.008). Conclusions: Relative wall thickness and LVOT diameter were independent predictors of obstruction. As a dichotomous variable, a relative wall thickness ≤ 0.44 was the only independent predictor of dynamic IVO. |
Palavras-chave: | dobutamine stress echocardiogram intraventricular obstruction outflow tract obstruction dynamic obstruction of the left ventricle systolic anterior motion of the mitral valve |
Editora / Evento / Instituição: | Wiley Blackwell |
URI: | http://www.repositorio.ufba.br/ri/handle/ri/6193 |
Data do documento: | 2009 |
Aparece nas coleções: | Artigo Publicado em Periódico (Faculdade de Medicina) |
Arquivo | Descrição | Tamanho | Formato | |
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(80)j.1540-8175.2009.00953.x.pdf Restricted Access | 238,13 kB | Adobe PDF | Visualizar/Abrir Solicitar uma cópia |
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