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Utility of dobutamine stress echocardiography in aortic valve regurgitation and reduced left ventricular function
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  • Chihiro Saito,
  • Kotaro Arai,
  • Kyomi Ashihara,
  • Hiroshi Niinami,
  • Nobuhisa Hagiwara
Chihiro Saito
Tokyo Women's Medical University

Corresponding Author:chipi.21sep@gmail.com

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Kotaro Arai
Tokyo Women's Medical University
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Kyomi Ashihara
Tokyo Women's Medical University
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Hiroshi Niinami
Tokyo Women's Medical University
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Nobuhisa Hagiwara
Tokyo Women's Medical University
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Abstract

Objective: Predictors for post-operative reverse remodeling in patients with severe aortic regurgitation (AR) and reduced left ventricular ejection fraction (LVEF) are unknown. We performed low-dose dobutamine stress echocardiography (DSE) in patients with severe AR and reduced LVEF to evaluate the relationship between contractile reserve (CR) and reverse remodeling after surgery. Methods: In 31 patients with chronic severe AR and reduced LVEF (LVEF < 50%), we performed pre-operative DSE, assessed CR and examined whether changes in preoperative DSE were associated with improvement of post-operative LVEF after aortic valve surgery. Results: The pre-operative echocardiographic findings were as follows: left ventricular (LV) end-diastolic dimension: 67 ± 10 mm, LV end-systolic dimension: 52 ± 13 mm and LVEF: 42% ± 8%. All patients underwent aortic valve surgery. Patients with pre-operative LVEF of >45% exhibited a significant increase in LVEF; however, patients with pre-operative LVEF of <45% showed no significant change. When we examined the results of DSE performed in patients with pre-operative LVEF of <45%, ΔLVEF of ≥6% (with CR) during DSE was related to an improvement in post-operative LVEF; ΔLVEF of ≥6% during DSE predicted an improvement in post-operative LVEF, with a sensitivity and specificity of 80% and 85%, respectively. Conclusions: DSE may be a helpful tool for predicting post-operative reverse remodeling in patients with severe AR and moderately reduced LVEF.
22 Sep 2021Submitted to Echocardiography
22 Sep 2021Submission Checks Completed
22 Sep 2021Assigned to Editor
25 Sep 2021Reviewer(s) Assigned
03 Nov 2021Review(s) Completed, Editorial Evaluation Pending
05 Nov 2021Editorial Decision: Revise Major
16 Dec 20211st Revision Received
16 Dec 2021Submission Checks Completed
16 Dec 2021Assigned to Editor
01 Jan 2022Reviewer(s) Assigned
18 Jan 2022Review(s) Completed, Editorial Evaluation Pending
24 Jan 2022Editorial Decision: Revise Minor
02 Feb 20222nd Revision Received
03 Feb 2022Submission Checks Completed
03 Feb 2022Assigned to Editor
03 Feb 2022Reviewer(s) Assigned
11 Feb 2022Review(s) Completed, Editorial Evaluation Pending
28 Feb 2022Editorial Decision: Accept
Apr 2022Published in Echocardiography volume 39 issue 4 on pages 599-605. 10.1111/echo.15334