Document Detail


Significance of low-dose dobutamine stress echocardiography for the prediction of the long-term prognosis for patients with acute myocardial infarction.
MedLine Citation:
PMID:  12674995     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Detection of stunned myocardium using low-dose dobutamine stress echocardiography is a good predictor of improvement of cardiac function in patients with acute myocardial infarction during short hospital stays. The present study evaluated the detection of stunned myocardium as a predictor of the long-term prognosis for patients with acute myocardial infarction. METHODS: One hundred and two patients (83 males, 19 females, mean age 61.5 years) with initial myocardial infarction underwent successful reperfusion therapy (direct percutaneous transluminal coronary angioplasty or stent) in the acute stage. Within 7 days, low-dose dobutamine was administered by intravenous drip and improvement of wall motion of the infarct area was evaluated by echocardiography. The patients were divided into two groups, the viable group that showed one grade or more improvement (61 patients), and the non-viable group that showed no improvement (41 patients). These groups were compared to determine the differences in clinical findings such as remodeling of the left ventricle measured by two-dimensional echocardiography, physical work capacity during serial multi-step exercise testing, and the prognosis. RESULTS: The viable group showed greater improvement in hemodynamics and wall motion of the infarct areas than the non-viable group. After discharge, the physical work capacity was significantly increased and there was no recognizable enlargement of the left ventricle in the viable group. No sudden cardiac death or heart failure occurred in the viable group, in contrast to incidences of 6% and 9%, respectively, in the non-viable group. Unstable angina and nonfatal re-infarction occurred more frequently in the viable group. CONCLUSIONS: The presence of stunned myocardium is a predictor of the prognosis for patients with acute myocardial infarction.
Authors:
Hiroyuki Kayano; Masaki Ozawa; Shuhaku Koh; Masami Sorimachi; Hiroaki Ueda; Kitaro Kawamura; Hiromi Andoh; Yasushi Akutsu; Masaichi Hasegawa; Takashi Katagiri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiology     Volume:  41     ISSN:  0914-5087     ISO Abbreviation:  J Cardiol     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-04-04     Completed Date:  2003-05-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  109-17     Citation Subset:  IM    
Affiliation:
Third Department of Internal Medicine, Showa University School of Medicine, Hatanodai 1-5-8, Shinagawa-ku, Tokyo 142-8666.
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MeSH Terms
Descriptor/Qualifier:
Dobutamine / diagnostic use*
Echoencephalography / methods*
Exercise Test*
Female
Heart / physiopathology
Hemodynamics / physiology
Humans
Male
Middle Aged
Myocardial Infarction / mortality,  physiopathology*,  ultrasonography
Prognosis
Treatment Outcome
Chemical
Reg. No./Substance:
34368-04-2/Dobutamine

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


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