Document Detail


Incremental value of myocardial contrast echocardiography for the prediction of recovery of function in dobutamine nonresponsive myocardium early after acute myocardial infarction.
MedLine Citation:
PMID:  12586251     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We hypothesized that the presence of microvascular integrity, detected by myocardial contrast echocardiography (MCE) in dobutamine nonresponsive segments, may enhance identification of recovery of function, which is a surrogate marker of myocardial viability. Accordingly, 96 patients underwent dobutamine echocardiography (DE) and intravenous MCE on the same day, 4.6 +/- 1.5 days after acute myocardial infarction (AMI). Recovery of function of akinetic segments was assessed at 3 months after AMI. Of 387 akinetic segments, 102 (26%) recovered function during follow-up. Sensitivities and specificities of MCE, DE, and the combination of DE and MCE in dobutamine nonresponsive segments were 58%, 59%, and 79%, respectively (p <0.001, compared with MCE and DE) and 76%, 84%, and 69%, respectively (p <0.05 compared with DE) for predicting recovery of function. In anterior AMI, the positive and negative predictive values of MCE, DE, and the combination of DE and MCE were 47% and 88%, 57% and 89%, and 49% and 95%, respectively. Multivariate analysis using clinical characteristics, electrocardiography, biochemical factors, MCE, and DE showed that the combination of DE and MCE in dobutamine nonresponsive segments (p <0.00001) and Q-wave AMI (p = 0.002) were the only independent predictors of recovery of function. Thus, for optimum prediction of recovery of function after AMI, a combination of DE and MCE in dobutamine nonresponsive segments may be utilized.
Authors:
Roxy Senior; Jonathan M Swinburn
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  The American journal of cardiology     Volume:  91     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-14     Completed Date:  2003-03-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  397-402     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Medicine, Northwick Park and St. Mark's Hospitals and Institute of Medical Research, Harrow, United Kingdom. roxy.senior@virgin.net
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiotonic Agents / diagnostic use*
Coronary Angiography
Coronary Circulation
Dobutamine / diagnostic use*
Echocardiography / methods*,  standards
Echocardiography, Stress / methods*,  standards
Electrocardiography
Female
Follow-Up Studies
Humans
Logistic Models
Male
Microcirculation
Middle Aged
Multivariate Analysis
Myocardial Infarction / classification,  physiopathology*,  therapy,  ultrasonography*
Myocardial Revascularization
Predictive Value of Tests
Prognosis
Recovery of Function*
Severity of Illness Index
Single-Blind Method
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine

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


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