| Incremental value of myocardial contrast echocardiography for the prediction of recovery of function in dobutamine nonresponsive myocardium early after acute myocardial infarction. | |
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MedLine Citation:
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PMID: 12586251 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Roxy Senior; Jonathan M Swinburn |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies |
Journal Detail:
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Title: The American journal of cardiology Volume: 91 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2003 Feb |
Date Detail:
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Created Date: 2003-02-14 Completed Date: 2003-03-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 397-402 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiovascular Medicine, Northwick Park and St. Mark's Hospitals and Institute of Medical Research, Harrow, United Kingdom. roxy.senior@virgin.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Cardiotonic Agents; 34368-04-2/Dobutamine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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