| Magnetic resonance tagging and echocardiographic response to dobutamine and functional improvement after reperfused myocardial infarction. | |
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MedLine Citation:
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PMID: 12075262 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Our objective was to compare the qualitative response to low-dose dobutamine by echocardiography (DSE) with the quantitative response of magnetic resonance myocardial tagging (DMRT) in the prediction and evaluation of functional improvement after reperfused myocardial infarction (MI). METHODS: Twenty-two patients with a reperfused first MI (aged 51 +/- 2 years, 20 male, 13 anterior MI) were studied. On day 3 +/- 1 after MI, patients underwent both DSE and DMRT at baseline and during infusion of 5 microg/kg/min and 10 microg/kg/min of dobutamine. The patients returned at week 8 +/- 1 for follow-up echocardiogram and MRT at rest. Two experienced observers interpreted the DSE for the presence of contractile reserve and functional improvement in dysfunctional segments. By DMRT, a 5% increase in percent intramyocardial circumferential shortening at peak response to dobutamine was defined as evidence of contractile reserve. Functional improvement by echocardiography was defined as the gold standard. RESULTS: Ejection fraction improved from 46% +/- 10% at week 1 to 51% +/- 12% at week 8 (P <.001) in the patients. Sixty-seven transmural segments with baseline dysfunction matched between imaging modalities by location were studied. For 51 (76%) of the segments, echocardiography and MR tagging were concordant in the assessment of functional improvement (kappa value 0.52). Twenty-nine segments (43%) demonstrated improvement by echocardiography, whereas 33 segments (49%) improved by MR tagging. With improvement of function by echocardiography as gold standard, the sensitivity and specificity of DMRT for prediction of functional improvement was 86% and 69%, respectively, with an overall accuracy of 76%. The sensitivity, specificity, and accuracy of DSE was 86%, 87%, and 85%, respectively. Overall accuracy was similar between techniques. CONCLUSIONS: Both DSMRT and DSE are sensitive and accurate techniques for predicting functional improvement after reperfused MI. |
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Authors:
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Christopher M Kramer; Michael J Malkowski; Sunil Mankad; Therese M Theobald; Diana L Pakstis; Walter J Rogers |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American heart journal Volume: 143 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2002 Jun |
Date Detail:
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Created Date: 2002-06-20 Completed Date: 2002-07-18 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 1046-51 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, the University of Virginia Health System, Charlottesville, Va 22908, USA. ckramer@virginia.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cardiotonic Agents
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administration & dosage,
diagnostic use* Dobutamine / administration & dosage, diagnostic use* Echocardiography* Female Humans Magnetic Resonance Imaging / methods* Male Middle Aged Myocardial Contraction Myocardial Infarction / physiopathology*, therapy, ultrasonography Myocardial Reperfusion Myocardial Stunning / physiopathology, therapy, ultrasonography Sensitivity and Specificity Stroke Volume |
| 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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