Document Detail


Prediction of reversible myocardial dysfunction by positron emission tomography, low-dose dobutamine echocardiography, resting ECG, and exercise testing.
MedLine Citation:
PMID:  11701938     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We studied different algorithms to identify patients with heart failure who could potentially benefit from revascularization. Thirty-five coronary artery bypass (graft) patients with an ejection fraction of 35 +/- 7% underwent preoperative 18F-fluoro-2-deoxyglucose positron emission tomography (PET), low-dose dobutamine echocardiography (LDDE), and exercise testing. Follow-up by echocardiography and coronary angiography was performed 6 months after coronary artery bypass grafting. The sensitivity for prediction of reversible myocardial dysfunction was highest for PET and for ST depression or angina pectoris during exercise testing (100 and 93%, p = NS), 71% for LDDE (p < 0.05 vs. PET), and 50% for resting ECG (p < 0.02 vs. PET and exercise test). The specificity did not differ between LDDE (81%), PET (67%), and resting ECG (71%), but was lowest for exercise testing (33%; p < 0.02 vs. PET, LDDE, and resting ECG). Accuracies were: PET 80%, LDDE 77%, exercise testing 62%, and resting ECG 58% (p < 0.05 vs. PET). In patients with a negative exercise test, recovery was unlikely, and further viability testing may not be needed. In patients with a positive test, recovery may occur, and additional PET or LDDE should be performed. In these cases, PET with an 18F-fluoro-deoxyglucose uptake of > or =70% as the criterion for viability yields optimum diagnostic characteristics. This strategy awaits further evaluation in larger patient populations with heart failure.
Authors:
H Wiggers; H Egeblad; T T Nielsen; H E Bøtker
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cardiology     Volume:  96     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:  2001  
Date Detail:
Created Date:  2001-11-09     Completed Date:  2002-01-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  32-7     Citation Subset:  IM    
Copyright Information:
Copyright 2001 S. Karger AG, Basel
Affiliation:
Department of Cardiology, Skejby Hospital, Aarhus University Hospitals, Aarhus, Denmark. henrikwiggers@dadlnet.dk
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MeSH Terms
Descriptor/Qualifier:
Aged
Algorithms
Echocardiography, Stress*
Electrocardiography*
Exercise Test*
Female
Follow-Up Studies
Heart Failure / complications,  diagnosis*
Humans
Male
Middle Aged
Myocardial Ischemia / complications,  diagnosis*
Predictive Value of Tests
Reproducibility of Results
Sensitivity and Specificity
Stroke Volume / physiology
Tomography, Emission-Computed*
Ventricular Dysfunction, Left / complications,  diagnosis*

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


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