Document Detail


Low-dose dobutamine in patients with acute myocardial infarction identifies viable but not contractile myocardium and predicts the magnitude of improvement in wall motion abnormalities in response to coronary revascularization.
MedLine Citation:
PMID:  1957746     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To assess the effects of coronary revascularization on viable but noncontractile myocardium, we examined 21 patients with a documented anterior acute myocardial infarction who had a significant improvement in wall motion abnormality evaluated by two-dimensional echocardiography in the infarct-related artery in response to low-dose dobutamine infusion. All patients had a significant residual stenosis in the infarct-related artery. In response to low-dose dobutamine, there was a marked improvement in contractility in the infarct-related area segments and this was reflected by a decrease in echocardiographic score index from 1.5 +/- 0.15 to 1.09 +/- 0.08 (p = 0.0001). Of these 21 patients, 13 underwent successful revascularization: 10 had percutaneous transluminal coronary angioplasty (PTCA) and three had coronary artery bypass grafts (CABG) (group I). Eight patients received medical therapy only (group II). At 40 +/- 15 days of follow-up, both groups had improvement in their segmental wall motion abnormalities. However, the improvement in group I was greater than that in group II, 1.1 +/- 0.13 and 1.35 +/- 0.1, respectively (p = 0.0002). We conclude that: (1) low-dose dobutamine infusion may identify viable but noncontractile myocardium in patients with acute myocardial infarction and (2) in these patients revascularization causes a greater improvement in left ventricular function over time when compared with a nonrevascularized group.
Authors:
F Barilla; M Gheorghiade; M Alam; F Khaja; S Goldstein
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  122     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1991-12-31     Completed Date:  1991-12-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1522-31     Citation Subset:  AIM; IM    
Affiliation:
Heart and Vascular Institute, Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI 48202.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography
Dobutamine / administration & dosage,  diagnostic use*
Echocardiography / methods
Electrocardiography
Female
Humans
Infusions, Intravenous
Male
Middle Aged
Myocardial Contraction / drug effects*
Myocardial Infarction / diagnosis*,  therapy
Myocardial Reperfusion*
Prognosis
Remission Induction
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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