Relation of the Contractile Reserve of Hibernating Myocardium to Myocardial Structure in Humans
Why the study?
Does contractile reserve during dobutamine echocardiography correlate with myocardial structure and predict functional recovery in patients with coronary disease undergoing bypass surgery?
Structured PICO
Does contractile reserve during dobutamine echocardiography correlate with myocardial structure and predict functional recovery in patients with coronary disease undergoing bypass surgery?
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Population
20 patients with coronary disease undergoing bypass surgery, mean age 64+/-13 years, mean ejection fraction 28+/-7.5%. 37 transmural myocardial segments biopsied.
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Intervention
Dobutamine echocardiography (up to 40 micrograms/kg/min), rest-redistribution 201Tl single photon emission CT, and quantitative angiography before bypass surgery, with transmural myocardial biopsies guided by transesophageal echocardiography during surgery.
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Outcome
Postoperative functional recovery assessed 2 to 3 months later, and correlation of contractile reserve with myocardial structure (interstitial fibrosis, intracellular and interstitial proteins).surrogate
Contractile reserve during dobutamine echocardiography correlates inversely with interstitial fibrosis and directly with thallium uptake, predicting functional recovery in hibernating myocardium.
Authors
Discussion
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Implication
Supports contractile reserve as viability marker in hibernating myocardium; leaves open whether it improves outcomes in prospective trials.
Cite This Study
Nagueh et al. (1999) studied this question.