Document Detail


Detection of functional recovery using low-dose dobutamine and myocardial contrast echocardiography after acute myocardial infarction treated with successful thrombolytic therapy.
MedLine Citation:
PMID:  15966934     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  22     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-06-21     Completed Date:  2005-11-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  496-502     Citation Subset:  IM    
Affiliation:
Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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