Document Detail

Comparison of low-dose dobutamine stress echocardiography and echocardiography during glucose-insulin-potassium infusion for detection of myocardial viability after anterior myocardial infarction.
MedLine Citation:
PMID:  12131017     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Low-dose dobutamine stress echocardiography (LDDSE) is one of the methods most used to assess myocardial viability. Glucose-insulin-potassium (GIK) infusion has been shown to increase contraction of the ischemic zone. The aim of this study was to compare LDDSE and echocardiography during GIK infusion for detection of myocardial viability. METHODS: Thirty-two patients who had first anterior myocardial infarction (MI) without previous MI were included in the study. Echocardiographic evaluation was carried out on the 7th +/- 2 days after MI. During continuous electrocardiographic, blood pressure and echocardiographic monitoring, an intravenous infusion of dobutamine (3 microg/kg body weight/min) was started with an infusion pump, continued for 5 min and then increased to 5 microg/kg/min and 10 microg/kg/min for another 5 min. The GIK protocol consisted of a fixed dose of insulin (100 microU/kg/h intravenously) and a variable glucose/potassium infusion rate. GIK echocardiography was done at baseline and after 60 min of GIK. The detected viable myocardium was defined as one or two scores decreasing in at least two adjacent abnormal segments during LDDSE and GIK echocardiography. RESULTS: Under resting conditions 225 segments (44%) were normokinetic, 21 segments (4%) dyskinetic, 117 segments (23%) akinetic and 149 segments (29%) hypokinetic. Viability was detected in 20% (57 segments) of the asynergic segments at baseline with GIK echocardiography and in 22% (62 segments) of those segments with LDDSE (P < 0.05). Left ventricular wall motion score index at baseline was 1.87 and it decreased significantly indicating improvement in left ventricular systolic function during both LDDSE and GIK echocardiography (P < 0.001, versus 1.75 and 1.76 respectively). The agreement between LDDSE and GIK echocardiography for detection of myocardial viability was 96%. CONCLUSION: We have shown that GIK echocardiography is similar to LDDSE for detection of myocardial viability. With the support of further clinical studies GIK echocardiography could be used to detect myocardial viability after acute MI.
Ertan Yetkin; Kubilay Senen; Mehmet Ileri; Ramazan Atak; Izzet Tandogan; Ozkan Yetkin; Feridun Kosar; Hasan Turhan; Sengül Cehreli
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Coronary artery disease     Volume:  13     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-07-19     Completed Date:  2002-09-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  145-9     Citation Subset:  IM    
Department of Cardiology, Faculty of Medicine, Inonu University Malatya, Turkey.
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MeSH Terms
Adrenergic beta-Agonists / administration & dosage*,  diagnostic use*
Blood Pressure / drug effects,  physiology
Cell Survival / physiology*
Dobutamine / administration & dosage*,  diagnostic use*
Dose-Response Relationship, Drug
Echocardiography, Stress*
Glucose / diagnostic use*
Heart Rate / drug effects,  physiology
Infusions, Intravenous
Insulin / diagnostic use*
Middle Aged
Myocardial Infarction / pathology,  physiopathology*
Myocardium / metabolism*
Potassium / diagnostic use*
Ventricular Function, Left / drug effects,  physiology
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/glucose-insulin-potassium cardioplegic solution; 11061-68-0/Insulin; 34368-04-2/Dobutamine; 50-99-7/Glucose; 7440-09-7/Potassium

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