| Postextrasystolic potentiation and dobutamine echocardiography in predicting recovery of myocardial function after coronary bypass revascularization. | |
| | |
MedLine Citation:
|
PMID: 9264487 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Identification of viable but hibernating myocardium remains a relevant issue in the current era of myocardial revascularization. Echocardiography can be helpful in detecting reversible contractile dysfunction and optimizing the selection of patients for coronary bypass surgery. METHODS AND RESULTS: Eighty-four consecutive candidates for bypass surgery with chronic multivessel coronary artery disease were screened, and 60 were included in this prospective study. Preoperative evaluation of a reversible contractile dysfunction in asynergic myocardial regions was performed by dobutamine infusion at 5 (low dose) and 10 (intermediate dose) microg x kg(-1) x min(-1) with each stage lasting at least 5 minutes; postextrasystolic potentiation (PESP), with a coupling interval ranging from 500 to 300 ms with a progressive 10-ms decrease; or a combination of both dobutamine infusion and PESP. Sensitivity (92% versus 86%) and predictive accuracy (89% versus 84%) were higher with PESP than dobutamine (P=.009 and P=.001, respectively), but the combination did not improve sensitivity or accuracy. Dobutamine induced ischemic dysfunction in 15% of patients at the intermediate dose; however, the low dose resulted in loss of sensitivity. CONCLUSIONS: PESP echocardiography is a useful and cost-effective method to identify viable myocardium in patients with multivessel coronary disease undergoing revascularization and is more sensitive and accurate than dobutamine infusion. |
| | |
Authors:
|
R Scognamiglio; G Fasoli; D Casarotto; M Miorelli; S Nistri; M Palisi; M Marin; S Dalla Volta |
Related Documents
:
|
7959537 - Enoximon-echocardiography. a new diagnostic approach for the detection of viable myocar... 9239427 - Cardiac disease in chronic uremia: investigation. 9040267 - Stress echocardiography using adenosine combined with nitroglycerin-dobutamine in the d... 11053717 - Use of fractional myocardial flow reserve to assess the functional significance of inte... 8144347 - Persistent postoperative ventricular tachycardia treatment by using external cardiopulm... 15071797 - Lipoprotein (a) in coronary artery disease in indian population. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Circulation Volume: 96 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1997 Aug |
Date Detail:
|
Created Date: 1997-09-15 Completed Date: 1997-09-15 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 816-20 Citation Subset: AIM; IM |
Affiliation:
|
Department of Clinical and Experimental Medicine, University of Padua, Italy. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Cardiac Complexes, Premature / physiopathology*, ultrasonography* Cardiotonic Agents / diagnostic use* Coronary Artery Bypass* Dobutamine / diagnostic use* Echocardiography* Female Follow-Up Studies Forecasting Heart / physiopathology* Humans Male Middle Aged Myocardial Contraction Postoperative Period Prospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Cardiotonic Agents; 34368-04-2/Dobutamine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Coronary angiographic characteristics of patients with permanent artificial pacemakers.
Next Document: Abnormal cardiac adrenergic nerve function in patients with syndrome X detected by [123I]metaiodoben...