Key result
A normal left ventricular end-diastolic volume response (≥10% decrease) during low-dose dobutamine stress echocardiography predicted a greater decrease in LVEDV at follow-up (-22.6% vs -2.0%, p<0.01).
Why the study?
Does LVEDV response during low-dose dobutamine stress echocardiography predict LV volume change during follow-up in patients with acute myocardial infarction?
Cohort (n=45)
Does LVEDV response during low-dose dobutamine stress echocardiography predict LV volume change during follow-up in patients with acute myocardial infarction?
LVEDV response during low-dose dobutamine stress echocardiography early after AMI can independently predict subsequent left ventricular remodeling.
May support early post-AMI remodeling risk stratification via low-dose DSE; leaves open prospective validation before guiding therapy.
OBJECTIVES: This study was performed to evaluate the significance of left ventricular (LV) volume response during dobutamine stress echocardiography (DSE) in the prediction of LV volume change during follow-up (F/U) in patients with acute myocardial infarction (AMI). METHODS: Forty-five patients with AMI (male 39, age 57+/-10 y, anterior myocardial infarction [MI] 29) underwent DSE 6+/-4 d after AMI. Revascularization of the infarct-related artery was performed if severe stenosis was present. A F/U echocardiography was performed 7.5+/-3.4 mo after DSE. The LV end-diastolic volume (EDV) and end-systolic volume (ESV) using the modified Simpson's method were measured at baseline echocardiography, low-dose (10 microg x kg(-1) x min(-1)) DSE, and F/U echocardiography. RESULTS: Patients were divided into 2 groups; Group I (n = 21) with an abnormal response (<10% decrease) in LVEDV during low-dose DSE; Group II (n = 24) with a normal response (> or =10% decrease) in LVEDV during low-dose DSE. At F/U echocardiography, the (%) change of LVEDV was significantly different between the 2 groups (-2.0+/-16.7 versus - 22.6+/-24.7%, p<0.01). Using multivariate analysis, the response of LVEDV (%) at low-dose DSE was the only significant independent predictor of the change of LVEDV (%) during F/U (y = 0.85 x - 0.03, r = 0.63, p<0.001). CONCLUSIONS: The response of LVEDV during DSE can be used as a predictor for the LV volume change after AMI.
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Rim et al. (2008) conducted a cohort in Acute myocardial infarction (n=45). Dobutamine stress echocardiography (DSE) vs. Abnormal response (<10% decrease in LVEDV) was evaluated on Change of LVEDV (%) at follow-up (p=<0.01). A normal left ventricular end-diastolic volume response (≥10% decrease) during low-dose dobutamine stress echocardiography predicted a greater decrease in LVEDV at follow-up (-22.6% vs -2.0%, p<0.01).
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