Dobutamine stress test in differential diagnostics of dilated ischemic cardiomyopathy

Abstract

Examining 81 patients with dilated cardiomyopathy (DCMP) and ischemic cardiomyopathy (ICMP), differential diagnostics criteria were identified. Group I included 45 patients with DCMP (43 males, 2 females), mean age 37,0+2,2 years. Group 2 consisted of 36 patients with coronary heart disease (CRD); mean age 59,3+2,3 years. Together with analyzing anamnesis, clinical data, complication features, instrumental methods were also used: ECG, Hotter monitoring, echocardiography (EchoCG). Cases difficult for diagnostics required endomyocardial biopsy, central hemodynamics assessment, coronaroangiography. In some participants, myocardial scintigraphy with Tl 201 was performed. Left ventricular contractility index (LV CI) was measured in 52 subjects. Thirty-six patients underwent dobutamine stress EchoCG (5-35 mg/kg/min), with assessing IV CI at baseline and after the test. In DCMP, total and local myocardial contractility was more severely impaired, right ventricular (RV) linear sizes were greater, and aorta dimensions decreased. In dobutamine stress test, DCMP and ICMP patients demonstrated contrary LV CI dynamics.