Document Detail


Myocardial viability assessed by dobutamine stress echocardiography predicts reduced mortality early after acute myocardial infarction: determining the risk of events after myocardial infarction (DREAM) study.
MedLine Citation:
PMID:  15831597     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To establish further the role of dobutamine stress echocardiography (DSE) in prognostication of outcome early after acute myocardial infarction (AMI) METHODS: Consecutive patients presenting with AMI were screened for inclusion into the study. 212 stable consenting patients underwent DSE a mean (SD) of 4.8 (1.5) days after AMI. Patients were then followed up for 803 (297) days.
RESULTS: The mean (SD) resting systolic wall thickening index (SWTI) was 1.6 (0.4), 44% patients had evidence of viability at low dose, and 38% had evidence of ischaemia. During the follow up period 27 (13%) patients died and 16 (8%) had a non-fatal AMI. Independent predictors of both mortality and combined mortality and non-fatal AMI were age (hazard ratio (HR) 1.04/year, p = 0.01, and HR 1.03/year, p = 0.04, respectively) and SWTI at low dose (HR 3.6, p < 0.01, and HR 2.5, p = 0.02, respectively). Low dose DSE provided incremental information over clinical and resting left ventricular function data for predicting death and non-fatal AMI. For patients who were not revascularised SWTI at peak dose dobutamine was the only independent predictor of mortality.
CONCLUSION: DSE is a powerful predictor of outcome in stable survivors of AMI. The presence of myocardial viability has a positive impact on survival.
Authors:
J M A Swinburn; R Senior
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-04-14
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  92     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-20     Completed Date:  2006-02-03     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  44-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Medicine, Northwick Park Hospital, Harrow, Middlesex, UK.
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MeSH Terms
Descriptor/Qualifier:
Echocardiography, Stress / mortality
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / mortality*
Predictive Value of Tests
Prognosis
Risk Assessment
Risk Factors
Survival Analysis
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