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Table 1 The spectrum of diagnostic applications of contractility in the stress echo lab

From: Myocardial contractility in the stress echo lab: from pathophysiological toy to clinical tool

  Author, year Stress Pts (n) Inclusion criteria Feasibility Intra observer variability Inter observer variability Results
CAD diagnosis         
  Bombardini, JASE 2003 [6] EX 50 Consecutive pts 100% (by selection) NA NA Biphasic PVR (<2 mmHg/ml/m2) with contractility loss at ischemia
Grosu, Eur Heart J 2005 [7] DOB 100 Abnormal LV function 100% (by selection) Within 2 SD* Within 2 SD* Biphasic PVR (<2 mmHg/ml/m2) with contractility loss at ischemia
Bombardini, Eur J Heart Fail 2005 [8] Pacing 26 Permanent PM 100% (by selection) NA NA Biphasic PVR (<2 mmHg/ml/m2) with contractility loss at ischemia
Bombardini, Int J Cardiol 2013 [8] DIP 111 Normal LV function 100% (by selection) NA NA Negative (<0 mmHg/ml/m2) PVR in positive tests
Contractile reserve in DCM         
  Otasevic, Eur J Heart Fail 2005 [21] DOB 24 Scheduled endomyocardial biopsy 88% NA NA Flat PVR (< 0.4 mmHg/ml/m2) in increased myocyte diameter
Cortigiani, Heart 2009 [19] DOB 233 Diabetics with negative stress 100% (by selection) 8% 11% Peak ESPVR < 28 mmHg/ml/m2 as events predictor
Ciampi, JASE 2010 [22] DOB 37 CHF center 89% Within 2 SD* Within 2 SD* Flat PVR (< 0.5 mmHg/ml/m2) in NYHA > II with increased BNP
Bombardini, Biomed Res Int 2013 [25] EX 18 Polycentric 96% Within 2 Within 2 Flat-negative
DIP 146 study   SD* SD* PVR (< 0.5 mmHg/ml/m2) in NYHA > II
DOB 58     
Contractile reserve in ischemic DC         
  Bombardini, Biomed Res Int 2013 [25] EX 36 Polycentric study 96% Within 2 SD* Within 2 SD* Positive correlation (R = 0.56, p = 0.000) with oxygen consumption
Bombardini, CU 2007 [27] EX 52 Comparisons with wearable contractility sensor   NA NA Post exercise contractility overshoot in abnormal flat PVR
Contractile reserve in MR         
  Agricola, Am J Cardiol 2005 [18] EX 63 Normal LV function in severe MR 100% 5% 4% Blunted PVR (< 2.1 mmHg/ml/m2) in stress induced pulmonary hypertension
Contractile reserve in diabetes         
  Jellis, Circ CI 2010 [28] EX 167 Apparently healthy type 2 diabetics 100% by selection NA NA PVR ≤ 12 mmHg/ml/m2 in subclinical myocardial disease
Contractile reserve in potential heart donors         
  Leone, IJHLT 2009 [26] DIP 18 Older donor hearts 100% NA NA CAD / myocardial disease of non transplanted hearts with abnormal negative (< 0 mmHg/ml/m2) PVR
  Bombardini, JASE 2011 [17] DIP 39 Older donor hearts 100% NA NA Normal coronary arteries and post-TX LV function in 19 hearts with up-sloping (> 0 mmHg/ml/m2) PVR
  Bombardini, CU 2103 [29] DIP 6 Stunned donor hearts 100% NA NA TX of hearts with viability response and positive (> 0 mmHg/ml/m2) PVR
  1. CAD = Coronary artery disease; CHF = Chronic heart failure; DC = Dilated ischemic cardiomyopathy; DCM = Idiopathic dilated cardiomyopathy; DIP = Dipyridamole; DOB = Dobutamine; EX = Exercise; LV = Left ventricle; MR = Mitral regurgitation; NA = Not available; PM = Pace-maker; PVR = Pressure-volume relation; TX = Heart transplant. *Both for intraobserver and interobserver analysis, > 95% of the differences were between d −2 SD and d +2 SD, as described by Bland and Altman.
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