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Dobutamine-atropine stress echocardiography for risk stratification in patients with chronic left ventricular dysfunction

^a Medical College of Wisconsin, Division of Cardiovascular Medicine, Milwaukee, Wisconsin, USA

View larger version (20K): [in a new window]   Figure 1 Bar graph of hard cardiac events according to DASE. Hard events were uncommon in patients with sustained improvement (Sustained Imp) and scar alone but were common (*, p < 0.01 vs. scar only or sustained improvement) in medically-treated patients with inducible ischemia. Hard events were uncommon (, p < 0.01) in patients with inducible ischemia treated with revascularization.

View larger version (22K): [in a new window]   Figure 2 Kaplan-Meier curves of hard event free survival according to DASE. Hard event free survival was good and similar (2 = 2.76, p = 0.1) in patients with sustained improvement and scar alone and poor (2 = 83.4, p < 0.0001) in patients with inducible ischemia. Hard event free survival was also similar (2 = 0.12, p = 0.73) in the subsets with biphasic (Biphasic) and worsening wall motion at peak dose only (WWM Peak Only), but events tended to occur earlier in those with biphasic responses. Hard event free survival was better (2 = 44.5, p < 0.0001) in patients with inducible ischemia treated with revascularization.

View larger version (21K): [in a new window]   Figure 3 Kaplan-Meier survival curves according to DASE. Survival was good and similar (2 = 1.1, p = 0.3) in patients with sustained improvement and scar alone. Survival was poor (2 = 52.2, p < 0.0001) in patients with inducible ischemia. Survival was worse (2 = 67.8, p < 0.0001 vs. scar or sustained improvement and 2 = 5.4, p = 0.02 vs. worsening wall motion at peak dose only) in the subset of patients with biphasic responses. Early and late deaths were common in patients with biphasic responses. Fatal events only occurred late in follow-up in patients with worsening wall motion at peak dose only (2 = 14.5, p = 0.0001 vs. scar or sustained improvement). Survival was better (2 = 27.7, p < 0.0001) in patients with inducible ischemia treated with revascularization. See Figure 2 for abbreviations.