Document Detail


Prognostic value of dobutamine echocardiography in patients after Q-wave or non-Q-wave acute myocardial infarction.
MedLine Citation:
PMID:  9671006     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We investigated the role of dobutamine echocardiography in predicting future spontaneous events in patients with Q-wave or non-Q-wave first acute myocardial infarction (AMI). DE was performed in 168 patients with a Q-wave AMI and 105 patients with a non-Q-wave AMI. Patients were observed for hard events (cardiac death and nonfatal reinfarction) and all spontaneous events (hard events and unstable angina). When compared to patients with a Q-wave AMI, patients with non-Q-wave AMI had a higher rate of positive dobutamine echocardiographic results (51.8% vs 80.0%, p <0.0001), greater changes in wall motion score index (WMSI) (0.31+/-0.17 vs 0.42+/-0.23, p = 0.001), and more remote zone ischemia (27.9% vs 43.8%, p = 0.0072). Patients with non-Q-wave infarct had a higher all-event rate, but a similar hard-event rate. In patients with a positive dobutamine echocardiogram (DE), the rate of hard or all events was similar, regardless of different infarct patterns. Patients with a negative DE had a higher event-free survival rate for all events in both Q-wave (85.2% vs 60.9%, p <0.0001) and non-Q-wave (76.2% vs 52.4%, p = 0.0083) groups. By stepwise analysis in the Q-wave group, the most important predictors were peak stress WMSI and diabetes for hard events, and a positive DE and baseline WMSI for all events. However, in the non-Q-wave group, the strongest predictors were dobutamine time for hard events and positive DE for all events. We conclude that a positive DE is a powerful predictor of future spontaneous events in patients after either a Q-wave or non-Q-wave AMI. However, for hard events, high-risk patients with different infarct patterns were recognized with variable efficiency by different dobutamine echocardiographic variables.
Authors:
C H Wang; W J Cherng; C C Hua; M J Hung
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  82     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-08-05     Completed Date:  1998-08-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  38-42     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Chang Gung Medical College, Chang Gung Memorial Hospital, Keelung, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiotonic Agents / diagnostic use*
Disease-Free Survival
Dobutamine / diagnostic use*
Echocardiography, Doppler / methods*
Female
Heart Conduction System / physiopathology*
Humans
Male
Middle Aged
Myocardial Infarction / physiopathology,  ultrasonography*
Predictive Value of Tests
Prognosis
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine

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


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