Document Detail

Tissue velocity imaging during dobutamine stimulation for assessment of myocardial viability: segmental analysis in patients after myocardial infarction.
MedLine Citation:
PMID:  16087258     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Dobutamine stress echocardiography (DSE) is an established method for the detection of viable myocardium, but evaluation of this method is subjective. Tissue velocity Imaging (TVI) allows quantitative analysis of regional myocardial wall motion by assessment of systolic myocardial velocities. The aim of this study was to evaluate the diagnostic value of DSE and TVI for detection of viable myocardium. METHODS: In 56 patients (58+/-12 years) with previous myocardial infarction (130+/-42 days, mean ejection fraction 42+/-15%) low-dose DSE was combined with analysis of peak systolic myocardial velocities (Vpeak) by TVI for assessment of myocardial viability. As reference served a follow-up echocardiography after successful revascularization (mean 91+/-3 days). RESULTS: Of a total of 896 segments 200 showed abnormal wall motion (31 mildly hypokinetic, 50 severely hypokinetic, 115 akinetic, 4 dyskinetic). In 125 of these 200 segments regional improvement of regional wall motion was observed (62.5% viable). An increase of Vpeak>1 cm/s during dobutamine stimulation allowed the identification of viable myocardium with a sensitivity of 82% and a specificity 82% (DSE: 77% and 80%). By receiver operating characteristic (ROC) curve analysis, a cut-off value of 1.0 cm/s was the best parameter to differ viable from nonviable myocardium (area under the curve 0.85; p<0.01; 95% CI 0.79 to 0.90). Improvement of global ejection fraction after revascularization (47+/-13%, p=0.11) corresponded with three TVI viable segments with a sensitivity of 92% and a specificity of 89% (p=0.012). CONCLUSIONS: TVI allows the identification of viable myocardium during dobutamine stimulation and enables a quantitative interpretation of DSE.
Carsten Schneider; Edda Bahlmann; Rainer Malisius; Klaus Hertting; Matthias Antz; Karl-Heinz Kuck
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Publication Detail:
Type:  Journal Article     Date:  2005-08-08
Journal Detail:
Title:  International journal of cardiology     Volume:  110     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-25     Completed Date:  2006-11-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  15-21     Citation Subset:  IM    
Department of Cardiology, St. George Hospital, Hamburg, Germany.
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MeSH Terms
Cardiotonic Agents / diagnostic use*
Dobutamine / diagnostic use*
Echocardiography, Stress*
Middle Aged
Myocardial Infarction / diagnosis*
Sensitivity and Specificity
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine

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