Document Detail


Longitudinal Doppler strain measurement for assessment of damaged and/or hibernating myocardium by dobutamine stress echocardiography in patients with old myocardial infarction.
MedLine Citation:
PMID:  20350508     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The ratio of systolic lengthening to combined late and postsystolic shortening (L/TS ratio) on longitudinal Doppler strain imaging (Doppler SI) may be an index of myocardial viability. We hypothesized that measuring the postsystolic index (PSI) and the L/TS ratio during dobutamine stress echocardiography (DSE) could quantitatively identify viable myocardium with the potential for regional functional recovery. METHODS: Thirty-eight patients with old myocardial infarction (OMI) underwent DSE with Doppler SI and coronary angiography (Group 1). To clarify the value of measuring the PSI and L/TS ratio by DSE with Doppler SI in patients with OMI, these Doppler parameters and visual analysis of wall motion abnormality (WMA) were compared on a segmental basis. To investigate the prediction of regional functional recovery, 10 patients with OMI (Group 2) and stenosis of the infarct-related coronary artery underwent DSE with Doppler SI before and after percutaneous coronary intervention. RESULTS: In Group 1, 143 out of 556 segments showed a biphasic WMA pattern during DSE. There were no segments with evidence of necrosis. The PSI at peak stress was > or =0.25 in 114 out of 143 segments and the L/TS ratio at peak stress was >0 in 82 out of 114 segments. Regarding functional recovery, 42 of the 73 segments with WMA at rest showed improvement after reperfusion. The wall motion score (WMS) showed 86% sensitivity and 71% specificity for predicting regional recovery, while PSI and L/TS ratio showed 61% vs. 84% sensitivity and 60% vs. 79% specificity, respectively. The AUC for the ROC curve of the L/TS ratio as a predictor of regional recovery was significantly larger compared with that of WMS (0.894 vs. 0.783, p<0.05). CONCLUSIONS: The peak stress L/TS ratio could be a specific and quantitative marker for identifying myocardial viability that has the potential for regional functional recovery.
Authors:
Hiroyuki Fujimoto; Hiroshi Honma; Tadaaki Ohno; Kyoichi Mizuno; Shinichiro Kumita
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Publication Detail:
Type:  Journal Article     Date:  2010-02-08
Journal Detail:
Title:  Journal of cardiology     Volume:  55     ISSN:  0914-5087     ISO Abbreviation:  J Cardiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-08-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  309-16     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Internal Medicine, Division of Cardiology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. fujihiro@eurus.dti.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography
Dobutamine / diagnostic use
Echocardiography, Stress*
Female
Heart / physiology*
Humans
Longitudinal Studies
Male
Myocardial Infarction / ultrasonography*
Myocardial Stunning / ultrasonography*
Observer Variation
Sensitivity and Specificity
Systole / physiology
Tissue Survival*
Chemical
Reg. No./Substance:
34368-04-2/Dobutamine

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


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