Dobutamine Echocardiography for Detection of Viable Myocardium in Ischemic Cardiomyopathy

In patients with ischemic cardiomyopathy, revascularization of hibernating or stunned myocardium can result in improvement in global systolic function and prognosis. The recognition that revascularization can alter the course of ischemic cardiomyopathy has fueled the development of noninvasive methods for detection of viable myocardium. Dobutamine echocardiography has established utility as a method for identifying hibernating and stunned myocardium thereby improving the selection of candidates with ischemic cardiomyopathy for revascularization. This manuscript reviews the rationale and methodology for use of low and high dose dobutamine echocardiography for detection of viable myocardium. The predictive value of the technique is discussed and compared with that of other noninvasive imaging methods.