Titre : | Reduced inotropic reserve is predictive of further degradation in left ventricular ejection fraction in patients with Duchenne muscular dystrophy. |
Revue : | European journal of heart failure, 17, 2 |
Auteurs : | Goudot FX ; Wahbi K ; Aïssou L ; Sorbets E ; Siam-Tsieu V ; Eymard B ; Themar Noel C ; Devaux JY ; Dessault O ; Duboc D ; Meune C |
Type de document : | Article |
Année de publication : | 02/2015 |
Pages : | p. 177-81 |
Langues: | Anglais |
Mots-clés : | étude longitudinale ; étude transversale |
Résumé : |
AIMS: Duchenne muscular dystrophy (DMD), an inherited X-linked muscular disease, is associated with dilated cardiomyopathy that is responsible for death in 40% of patients. Our objective was to determine whether inotropic reserve is predictive of LV trend over time.
METHODS AND RESULTS: A total of 69 DMD patients (age 12.2+2.3 years) were investigated. At baseline, LVEF and the presence of inotropic reserve (defined as an increase in LVEF >10% during dobutamine infusion) were investigated using radionuclide ventriculography. During follow-up (FU), LVEF was remeasured after a mean 29+19 months delay. In the whole population, mean LVEF was 58+8% at baseline and declined to 54+11% during FU (P =0.004). At baseline, 21 patients (30.4%) had LVEF <55% and 38 had no LV inotropic reserve. LVEF declined in the 38 patients (55.1%) without LV inotropic reserve (58+8% to 52+10%, P =0.001), and not in the other patients (58+8% to 57+11%, P =0.516) (P =0.042 for trends in LVEF between groups after adjustment for age, FU duration, and baseline LVEF). Fewer patients with vs. without inotropropic reserve at baseline show a depressed LVEF <55% during follow-up(35.5% vs. 63.2%, respectively, P =0.030). Similar findings were observed in the subgroups of patients with LVEF >45% or 55% at baseline. CONCLUSION: Inotropic reserve assessment allows the distinction of DMD patients who will vs. those who will not show a deterioration in LVEF, thus offering a sensitive approach for delineating the presence and progression of cardiovascular disease in these patients. |
Pubmed / DOI : | Pubmed : 25823361 |
En ligne : | http://www.ncbi.nlm.nih.gov/pubmed/25823361 |