**6. Conclusion**

In conclusion, the occurrence of dobutamine-induced MA is a potentially useful clinical predictor of poor prognosis in ambulatory patients with IDCM in sinus rhythm. Recent guidelines for the management of heart failure emphasize the need for earlier identification of and therapy for patients who are at high risk of developing heart failure or who have asymp‐ tomatic LV systolic dysfunction.[13] The prevalence of cardiac events or cardiac death was higher in patients with dobutamine- and pacing- induced MA than in those without it. Assessment of dobutamine-induced MA in addition to routine clinical evaluation in patients with IDCM may thus contribute to stratification of individuals into low- or high-risk groups. The identification of pacing- or dobutamine-induced MA requires an invasive examination and time-consuming hemodynamic stress assessment. The current trend in clinical medicine is to find a non-invasive test with prognostic consequences. However, the hemodynamic phenomenon by dobutamine stress testing might be also potentially useful marker for predicting the occurrence of cardiac events.

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