Otasevic, Petar (55927970400)Petar (55927970400)OtasevicPopovic, Z.B. (7101961971)Z.B. (7101961971)PopovicVasiljevic, J.D. (6602083697)J.D. (6602083697)VasiljevicPratali, L. (6603105724)L. (6603105724)PrataliVlahovic-Stipac, A. (14322720800)A. (14322720800)Vlahovic-StipacBoskovic, S.D. (16038574100)S.D. (16038574100)BoskovicTasic, N. (6603322581)N. (6603322581)TasicNeskovic, A.N. (35597744900)A.N. (35597744900)Neskovic2025-06-132025-06-132006https://doi.org/10.1136/hrt.2005.073999https://www.scopus.com/inward/record.uri?eid=2-s2.0-33748048789&doi=10.1136%2fhrt.2005.073999&partnerID=40&md5=1fb7fd3ad1943e0330cab3b7eca72151https://remedy.med.bg.ac.rs/handle/123456789/10858Objective: To compare head to head the indices of left ventricular contractile reserve assessed by high-dose dobutamine in the five-year prognosis of patients with idiopathic dilated cardiomyopathy. Design and setting: Prospective study in a tertiary care centre. Patients: 63 consecutive patients with idiopathic dilated cardiomyopathy. Interventions: High-dose dobutamine stress echocardiography was performed in progressive stages lasting 5 min each. Wall motion score index, ejection fraction, cardiac power output and end systolic pressure to volume ratio were evaluated as indices of left ventricular contractility. Main outcome measure: Five-year cardiac mortality. Results: During the follow up of 59 patients, 27 (45.8%) died of cardiac causes. According to Kaplan-Meier and receiver operating characteristic analyses all indices of contractile reserve differentiated patients with respect to cardiac death. Wall motion score index achieved the best separation (log rank 21.75, p < 0.0001, area under the curve 0.84), followed by change in ejection fraction (log rank 11.25, p = 0.0008, area under the curve 0.79), end systolic pressure to volume ratio (log rank 14.32, p = 0.0002, area under the curve 0.75) and cardiac power output (log rank 9.84, p = 0.0017, area under the curve 0.71). Cox's regression model identified wall motion score index as the only independent predictor of cardiac death. Conclusions: These data show that all examined indices of left ventricular contractile reserve are predictive of five-year prognosis, but change in wall motion score index may have the greatest prognostic potential.