| Prognostic value of myocardial viability recognized by low-dose dobutamine echocardiography in chronic ischemic left ventricular dysfunction. | |
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MedLine Citation:
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PMID: 14636900 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This study assesses the prognostic value of myocardial viability recognized as a contractile response to inotropic stimulation in patients with left ventricular (LV) dysfunction in a large-scale prospective, multicenter, observational study. Four hundred twenty-five patients (mean age 61 +/- 10 years) with angiographically proven coronary artery disease, previous (>3 months) myocardial infarction, and severe LV dysfunction (ejection fraction <35%; mean 28 +/- 6%) were enrolled in the study. Each patient underwent low-dose dobutamine echocardiography (up to 10 microg/kg/min). Myocardial viability was identified as a rest-stress variation (Delta) in the wall motion score index (WMSI), in which each segment was scored from 1 = normal to 4 = dyskinetic in a 16-segment model of the left ventricle. Myocardial viability was identified as an improvement of >/=0.40 in WMSI. All patients were followed for a median of 3.1 years. One hundred eighty-eight were revascularized either by coronary artery bypass grafting (n = 118) or coronary angioplasty (n = 70). The only end point analyzed was cardiac death. In the revascularized group, cardiac death occurred in 4 of the 52 patients with and in 37 of the 136 patients without myocardial viability (7.7% vs 27.2%, p <0.003). Kaplan-Meier survival estimates showed a better outcome for those patients with compared to patients without myocardial viability who underwent coronary revascularization (90.1% vs 62%, p <0.0078). Thus, in severe LV ischemic dysfunction, myocardial viability by low-dose dobutamine echocardiography is associated with improved survival in revascularized patients. |
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Authors:
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Rosa Sicari; Eugenio Picano; Lauro Cortigiani; Adrian C Borges; Albert Varga; Caterina Palagi; Riccardo Bigi; Roberta Rossini; Emilio Pasanisi; |
Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: The American journal of cardiology Volume: 92 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2003 Dec |
Date Detail:
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Created Date: 2003-11-25 Completed Date: 2004-01-21 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1263-6 Citation Subset: AIM; IM |
Affiliation:
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CNR, Institute of Clinical Physiology, Pisa, Italy. rosas@ifc.cnr.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cardiotonic Agents
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diagnostic use* Chronic Disease Dobutamine / diagnostic use* Echocardiography / methods* Female Humans Male Middle Aged Myocardial Ischemia / physiopathology*, ultrasonography* Myocardium / pathology* Predictive Value of Tests Prognosis Proportional Hazards Models Prospective Studies Survival Rate Ventricular Dysfunction, Left / physiopathology*, ultrasonography* |
| Chemical | |
Reg. No./Substance:
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0/Cardiotonic Agents; 34368-04-2/Dobutamine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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