February 15, 1995Circulation
Relation Between Thallium Uptake and Contractile Response to Dobutamine
Key result
Thallium scintigraphy identified viability in 84% of myocardial segments with resting wall motion abnormalities, whereas dobutamine echocardiography showed contractile improvement in 56% (P<0.0001).
Why the study?
Does thallium uptake correlate with the inotropic response to dobutamine in assessing myocardial viability in patients with chronic coronary artery disease and left ventricular dysfunction?
Population
30 patients with chronic coronary artery disease and impaired left ventricular systolic function at rest
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
Thallium and dobutamine echo yield discordant viability results in akinetic segments; leaves open which better predicts recovery after revascularization in ischemic LV dysfunction.
Study Design
Type
Observational (n=30)
Structured PICO
Does thallium uptake correlate with the inotropic response to dobutamine in assessing myocardial viability in patients with chronic coronary artery disease and left ventricular dysfunction?
P
Population
30 patients (28 men, 2 women; mean age 59 +/- 10 years) with chronic coronary artery disease and impaired left ventricular systolic function at rest (mean ejection fraction 32 +/- 9%)
I
Intervention
Transesophageal echocardiography during incremental doses of dobutamine (2.5 to 40 micrograms/kg/min) and SPECT thallium scintigraphy (stress-redistribution-reinjection protocol)
O
Outcome
Relation between thallium uptake and inotropic response to dobutamine in myocardial segments with resting wall motion abnormalitiessurrogate
Main Result
Absolute Event Rate: 56% vs 84%
p-value: p=< .0001
Thallium scintigraphy identifies more viable myocardial segments than dobutamine echocardiography, suggesting that inotropic response requires a higher degree of myocyte functional integrity than thallium uptake.
Cite This Study
Panza et al. (1995) conducted an observational in chronic coronary artery disease and left ventricular dysfunction (n=30). Dobutamine echocardiography vs. Thallium scintigraphy was evaluated on Viability in segments with resting wall motion abnormalities (p=< .0001). Thallium scintigraphy identified viability in 84% of myocardial segments with resting wall motion abnormalities, whereas dobutamine echocardiography showed contractile improvement in 56% (P<0.0001).