The prognostic impact of coronary flow reserve assessed by Doppler echocardiography in non-ischemic dilated cardiomyopathy (Articolo in rivista)

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  • The prognostic impact of coronary flow reserve assessed by Doppler echocardiography in non-ischemic dilated cardiomyopathy (Articolo in rivista) (literal)
Anno
  • 2006-01-01T00:00:00+01:00 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#doi
  • 10.1093/eurheartj/ehi795 (literal)
Alternative label
  • Rigo F.; Gherardi S.; Galderisi M.; Pratali L.; Cortigiani L.; Sicari R.; Picano E. (2006)
    The prognostic impact of coronary flow reserve assessed by Doppler echocardiography in non-ischemic dilated cardiomyopathy
    in European heart journal; Oxford University Press, Oxford (Regno Unito)
    (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori
  • Rigo F.; Gherardi S.; Galderisi M.; Pratali L.; Cortigiani L.; Sicari R.; Picano E. (literal)
Pagina inizio
  • 1319 (literal)
Pagina fine
  • 1323 (literal)
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  • http://eurheartj.oxfordjournals.org/content/27/11/1319.long (literal)
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  • 27 (literal)
Rivista
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  • In: European Heart Journal, vol. 27 pp. 1319-1323. Oxford Journals, 2006. (literal)
Note
  • ISI Web of Science (WOS) (literal)
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  • Cardiology Division, Umberto I Hospital, Mestre-Venice, Italy; Cardiology Division, Cesena Hospital, Cesena, Italy; Cardioangiology Unit, Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy; CNR, Institute of Clinical Physiology, Pisa, Italy; and Cardiology Division, Campo diMarte Hospital, Lucca, Italy (literal)
Titolo
  • The prognostic impact of coronary flow reserve assessed by Doppler echocardiography in non-ischemic dilated cardiomyopathy (literal)
Abstract
  • Aims Coronary flow-reserve (CFR) can be impaired in non-ischaemic dilated cardiomyopathy (DCM), unmasking a coronary microcirculatory dysfunction of potential prognostic impact. The aim of the present study is to evaluate the prognostic value of Doppler echocardiographic-derived CFR in patients with DCM. Methods and results We evaluated 129 DCM patients (85 male; age 62+11) by transthoracic dipyridamole (0.84 mg/kg in 10 min) stress echocardiography. All patients had an ejection fraction ,40% (mean 32+7) and angiographically normal coronary arteries with NYHA class = 3. CFR was assessed on left anterior descending artery using pulsed Doppler as the ratio of maximal peak vasodilation (dipyridamole) to rest diastolic flow velocity. All patients were followed-up for a median of 22 months. Mean CFR was 2.0+0.5. At individual patient analysis 46 patients had normal (CFR . 2.0) and 83 had abnormal CFR. During follow-up, 18 patients died and 33 showed worsening of NYHA class. The worse eventfree survival was observed in those patients with an abnormal CFR when compared with those having a normal CFR at high dose of dipyridamole (70 vs. 22%, at 75 months of follow-up, P , 0.0001). In the multivariable analysis, severity of mitral insufficiency (HR ¼ 1.9, 95% CI ¼ 1.06-2.87), abnormal CFR (HR ¼ 4.0, 95% CI ¼ 1.1-15.6), resting wall motion score index (HR ¼ 6.9, 95% CI ¼ 1.5-30.7) were independent predictors of survival. Conclusion In DCM patients, CFR is often impaired. A reduced CFR during vasodilator stress is an independent prognostic marker of bad prognosis. (literal)
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