Document Detail


Prediction of functional recovery of hibernating myocardium using harmonic power Doppler imaging and dobutamine stress echocardiography in patients with coronary artery disease.
MedLine Citation:
PMID:  12804726     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to compare the accuracy of harmonic power Doppler imaging (HPDI) and dobutamine stress echocardiography (DSE) in predicting recovery of myocardial function after bypass surgery. HPDI using triggering imaging with the administration of Levovist (Shering AG, Berlin, Germany) and DSE were performed in 34 patients (mean age 64 +/- 5 years) with left ventricular dysfunction. A repeat echocardiogram at rest was performed 3 months after revascularization. Of the 408 revascularized dysfunctional segments, 188 (45%) improved on the repeat echocardiogram. HPDI exhibited overall similar sensitivity (88% vs 87%) and accuracy (74% vs 79%) but lower specificity (61% vs 72%, p<0.05) compared with DSE for predicting recovery of myocardial function. Only delayed opacification at the 1:8 triggering point, demonstrated in 62% of viable segments, exhibited higher sensitivity (63%) and positive (58%) and negative (66%) predictive values than early opacification at 1:4 (25%, p<0.001; 35%, p<0.001; and 49%, p<0.001, respectively) in predicting functional recovery. The presence of contrast enhancement within the revascularized area resulted in a significant improvement after revascularization in wall motion score index and ejection fraction compared with areas with residual contrast defect (1.9 +/- 0.3 vs 2.3 +/- 0.3, p<0.01; 36 +/- 6% vs 29 +/- 5%, p<0.01, respectively). Significant correlations were observed between the contrast score index and the follow-up wall motion score index (r = -0.67) and between the contrast score index and the follow-up ejection fraction change (r = 0.65). Triggered HPDI has high sensitivity in detecting hibernating myocardium and can accurately predict the potential for recovery of ischemic left ventricular dysfunction 3 months after revascularization.
Authors:
Constadina Aggeli; Christodoulos Stefanadis; Maria Bonou; Christos Pitsavos; Constantinos Theocharis; George Roussakis; Constantinos Chatzos; Stela Brili; Pavlos Toutouzas
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  91     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-13     Completed Date:  2003-07-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1415-20     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Hippokration Hospital, University of Athens, 47 Georgiou Papandreou Zografou, Athens, Greece 15773. caggeli@hol.gr
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography
Coronary Artery Disease / diagnosis*,  physiopathology*,  surgery
Dyskinesias / diagnosis,  etiology,  physiopathology
Echocardiography, Doppler*
Echocardiography, Stress*
Female
Follow-Up Studies
Greece
Heart Ventricles / physiopathology,  surgery
Humans
Male
Middle Aged
Myocardial Contraction / physiology
Myocardial Revascularization
Myocardial Stunning / diagnosis*,  physiopathology*,  surgery
Myocardium / pathology
Postoperative Complications / diagnosis,  etiology,  physiopathology
Predictive Value of Tests
Recovery of Function / physiology*
Sensitivity and Specificity
Severity of Illness Index
Stroke Volume / physiology
Treatment Outcome
Ventricular Dysfunction, Left / diagnosis,  physiopathology,  surgery

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


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