Abstract
Background. Coronary flow reserve (CFR) on left anterior descending (LAD) can be reduced in non-ischemic dilated cardiomyopathy (DCM). Pressure-volume relationship (PVR) is a useful method for evaluating LV myocardial contractility during stress echocardiography (SE). Aim of the study was to assess the relationship between CFR on LAD and PVR in DCM patients. Methods. Sixty DCM patients (36 men; 63±13 years, mean value of ejection fraction: 36±7%) underwent dipyridamole stress echo (dypSE, 0.84 mg/kg in 6′). CFR was defined as the ratio between maximal vasodilation and rest peak diastolic flow velocity in LAD. PVR was defined as systolic cuff pressure/end-systolic volume index difference between rest-peak dypSE. Results. PVR was inversely related to wall motion score index at rest (r=-.424, p=.001) and at peak dypSE (r=-.528, p<.001), and directly related to E wave deceleration time (r=.365, p=.014). PVR was not related to ejection fraction at rest, and directly related to ejection fraction at peak dypSE (r=.482, p<.001). CFR on LAD was abnormal (<2) in 25/60 (42%) patients. PVR was directly related to CFR on LAD (r=.412, p=.001, Figure). Conclusions. In DCM patients, the presence of myocardial contractile reserve is directly related to CFR on LAD.
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