| Detection of functional recovery using low-dose dobutamine and myocardial contrast echocardiography after acute myocardial infarction treated with successful thrombolytic therapy. | |
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MedLine Citation:
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PMID: 15966934 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We studied the value of low-dose dobutamine stress echocardiography (LDDE) and myocardial contrast echocardiography (MCE) in early prediction of left ventricular functional recovery (LVFR) after acute myocardial infarction (AMI) treated with successful thrombolysis. DESIGN: LDDE and MCE using second-harmonic intermittent imaging were performed in first week after AMI. LVFR was defined as an absolute > or =5% increase in ejection fraction, from early to 6 months of follow-up by Technetium-99m-Sestamibi single-photon emission computed tomography. PATIENTS: Out of 50 patients studied, 19 evolved with LVFR (group 1) and 31 without LVFR (group 2). Regional dysfunction was detected in 103 (37%) infarcted-related segments in group 1 and in 173 (63%) segments in group 2. RESULTS: Sensitivity, specificity, positive, and negative predictive values and accuracy for detecting LVFR by LDDE were 94.7% (18/19), 87.1% (27/31), 81.8% (18/22), 96.4% (27/28), and 90% (45/50), respectively, and by MCE were 94.7% (18/19), 51.6% (16/31), 54.5% (18/33), 94.1% (16/17), and 68% (34/50). In group 1, functional improvement was observed in 86.9% (53/61) of segments with contractile reserve by LDDE and in 65.8% (52/79) of segments with microvascular perfusion by MCE. In group 2, functional improvement was observed in 78.3% (18/23) of segments with contractile reserve by LDDE and in 25.5% (25/98) of segments with microvascular perfusion by MCE. All segments without perfusion by MCE evolved without functional recovery. CONCLUSION: LDDE was an accurate predictor of late left ventricular function recovery after AMI, while MCE was sensitive and has a high negative predictive value demonstrating that microvascular perfusion is essential for LVFR. |
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Authors:
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João Cesar Nunes Sbano; Jeane Mike Tsutsui; José Lazaro Andrade; José Carlos Nicolau; José Claudio Meneghetti; José Franchini Ramires; Wilson Mathias |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Echocardiography (Mount Kisco, N.Y.) Volume: 22 ISSN: 0742-2822 ISO Abbreviation: Echocardiography Publication Date: 2005 Jul |
Date Detail:
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Created Date: 2005-06-21 Completed Date: 2005-11-10 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8511187 Medline TA: Echocardiography Country: United States |
Other Details:
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Languages: eng Pagination: 496-502 Citation Subset: IM |
Affiliation:
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Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Chi-Square Distribution Contrast Media Echocardiography* Echocardiography, Stress* Female Humans Male Middle Aged Myocardial Contraction Myocardial Infarction / drug therapy*, radionuclide imaging, ultrasonography* Predictive Value of Tests Prospective Studies Recovery of Function Sensitivity and Specificity Statistics, Nonparametric Thrombolytic Therapy* Tomography, Emission-Computed, Single-Photon |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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