Document Detail

Predischarge low-dose dobutamine test and prediction of left ventricular function at 1 year in patients with a first anterior myocardial infarction.
MedLine Citation:
PMID:  17063949     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It is unclear whether spontaneous improvement in contractility following acute myocardial infarction (AMI) is related to severity of predischarge systolic dysfunction and can be predicted by isotopic ventriculography with a low-dose dobutamine test (DBT). HYPOTHESIS: Spontaneous improvement in contractility would be similar in patients with more preserved and those with depressed ventricular function, and a DBT test could predict it. METHODS: Left ventricular ejection fraction (LVEF), regional contractility score (RCS), and left ventricular end-diastolic volume index (EDVI) at predischarge, during DBT, and at 1 year were analyzed in 43 patients with a first anterior ST-elevation AMI. RESULTS: Changes produced by DBT in patients with LVEF < 40%, RCS > or = 3, or EDVI > or = 70 ml/m2 were smaller than in those observed at 1 year (LVEF: 30 +/- 5-35 +/- 7%, p < 0.001, vs. 39 +/- 10%, p = 0.005; RCS: 4.9 +/- 1.4-4.6 +/- 2.0, NS, vs. 3.4 +/- 2.0, p < 0.02; EDVI: 92 +/- 14-86 +/- 22, NS, vs. 78 +/- 23 ml/m2, p < 0.03). In contrast, in patients with EF > or = 40%, RCS < 3 or EDVI < 70 ml/m2, changes with DBT tended to be greater than those observed at 1 year (LVEF: 52 +/- 8-57 +/- 11%, p < 0.004 vs. 55 +/- 11%, p < 0.04); RCS: 1.1 +/- 0.9-0.8 +/- 0.8, NS, vs. 1.1 +/- 1.1, NS; and EDVI: 51 +/- 9-47 +/- 11, p < 0.005, vs. 54 +/- 13 ml/m2, NS). CONCLUSIONS: Among patients with a first anterior AMI, spontaneous improvement in contractility at 1 year was greatest in those with a more depressed ventricular function or a dilated ventricle, but its magnitude was underestimated by a predischarge DBT test.
Jaume Figueras; Josefa Cortadellas; Mario Missorici; Joan Castell; Jordi Soler Soler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  29     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-26     Completed Date:  2007-01-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  451-6     Citation Subset:  IM    
Unitat Coronària, Servei de Cardiologia, Hospital General Vall d'Hebron, P. Vall d'Hebron 119-129, 08035 Barcelona, Spain.
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MeSH Terms
Cardiotonic Agents / diagnostic use
Coronary Angiography
Dobutamine / diagnostic use
Exercise Test
Heart Function Tests*
Heart Ventricles / radionuclide imaging
Middle Aged
Myocardial Contraction / physiology*
Myocardial Infarction / physiopathology*
Radiopharmaceuticals / diagnostic use
Stroke Volume / physiology*
Technetium Tc 99m Sestamibi / diagnostic use
Tomography, Emission-Computed, Single-Photon
Reg. No./Substance:
0/Cardiotonic Agents; 0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi; 34368-04-2/Dobutamine

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