What does this research mean for the field?

Low-dose dobutamine gated myocardial SPECT detects a significantly greater proportion of viable myocardium in dysfunctional segments compared to dobutamine stress echocardiography, while demonstrating good overall agreement between modalities. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To compare the diagnostic efficacy of dobutamine gated myocardial SPECT against dobutamine stress echocardiography for detecting viable myocardium in patients with myocardial infarction.

March 3, 2014Nuclear Medicine ReviewOpen Access

Comparison of stress dobutamine echocardiography and stress dobutamine gated myocardial SPECT for the detection of viable myocardium

Q: What are the key findings of this study?

Low dose dobutamine gated myocardial SPECT detected a significantly greater proportion of viable myocardium in dysfunctional segments compared to dobutamine stress echocardiography (39.2% vs 32.8%, p < 0.05).

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Myocardial infarction with stable left ventricular dysfunction (n=14). Intervention: Low dose dobutamine gated myocardial SPECT vs. Low dose dobutamine stress echocardiography. Primary outcome: Detection of viable myocardium in dysfunctional segments (p=<0.05).

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Key result

Low-dose dobutamine gated SPECT detects ~20% more viable myocardial segments than dobutamine stress echocardiography.

P<0.05
n=14

Why the study?

The efficacy of dobutamine gated myocardial SPECT compared with dobutamine stress echocardiography for detecting myocardial viability in MI patients was unclear.

Does dobutamine gated myocardial SPECT improve the detection of myocardial viability compared to dobutamine stress echocardiography in patients with myocardial infarction?

Population

14 patients with myocardial infarction candidates for surgical revascularization

Comparison

Dobutamine gated myocardial SPECT vs dobutamine stress echocardiography

Design

Prospective observational study

Authors

MAMina Taghizadeh AslBushehr University of Medical Sciences MMMohammad-Hossein MandegarShariati Hospital FRFarideh RoshanaliCardiac Imaging

Discussion

Member takes

Implication

Low dose dobutamine gated SPECT shows good agreement with stress dobutamine echocardiography for detecting myocardial viability in patients with prior myocardial infarction.

Key Points

To compare the diagnostic efficacy of dobutamine gated myocardial SPECT against dobutamine stress echocardiography for detecting viable myocardium in patients with myocardial infarction.
Evaluated 224 myocardial segments from 14 patients (13 men, 1 woman; mean age 54.57 years) with myocardial infarction scheduled for surgical revascularization.
Performed resting echocardiography and low-dose dobutamine stress echocardiography alongside resting, low-dose, and high-dose dobutamine 99mTc-Sestamibi gated SPECT.
Identified 125 dysfunctional segments at rest via ECG-gating, including 53 hypokinetic (23.66%), 64 akinetic (28.57%), and 8 dyskinetic (3.57%) segments.
Demonstrated that low-dose dobutamine ECG-gated SPECT identified significantly more viable segments than dobutamine stress echocardiography (39.2% vs. 32.8%, p < 0.05).
Observed viability in 42 of 125 dysfunctional segments (33.6%) during high-dose ECG-gated examination, with overall strong correlation between the two modalities.

Study Design

Type

Observational (n=14)

Blinding

Single-blind

Multicenter

Structured PICO

Does dobutamine gated myocardial SPECT improve the detection of myocardial viability compared to dobutamine stress echocardiography in patients with myocardial infarction?

Population

14 patients (mean age 54.6 years, 7.1% female) with previous myocardial infarction and stable left ventricular dysfunction who were candidates for surgical revascularization.

Intervention

Dobutamine gated myocardial SPECT (resting, low and high dose dobutamine stress 99mTc-Sestamibi gated SPECT)

Comparator

Dobutamine stress echocardiography (DSE) (resting and low dose)

Outcome

Detection of myocardial viability (inotropic reserve in infarcted areas)surrogate

Main Result

Absolute Event Rate: 39.2% vs 32.8%

p-value: p=<0.05

Low dose dobutamine gated SPECT shows good agreement with stress dobutamine echocardiography for detecting myocardial viability in patients with prior myocardial infarction.

Limitations

Inability to follow patients after coronary artery bypass surgery to determine functional recovery.
Possible misalignment between the 16-segment models used for DSE and SPECT data.
Limited number of dysfunctional segments included in the study.

Cite This Study

Asl et al. (2014) conducted an observational in Myocardial infarction with stable left ventricular dysfunction (n=14). Low dose dobutamine gated myocardial SPECT vs. Low dose dobutamine stress echocardiography was evaluated on Detection of viable myocardium in dysfunctional segments (p=<0.05). Low dose dobutamine gated myocardial SPECT detected a significantly greater proportion of viable myocardium in dysfunctional segments compared to dobutamine stress echocardiography (39.2% vs 32.8%, p < 0.05).

synapsesocial.com/papers/6ab7331e9a78714279d574b1 https://doi.org/10.5603/nmr.2014.0005

Topics

Echocardiography

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Implication

Low dose dobutamine gated SPECT shows good agreement with stress dobutamine echocardiography for detecting myocardial viability in patients with prior myocardial infarction.

Comparison of stress dobutamine echocardiography and stress dobutamine gated myocardial SPECT for the detection of viable myocardium

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Comparison of stress dobutamine echocardiography and stress dobutamine gated myocardial SPECT for the detection of viable myocardium

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider