Key result
Low-dose dobutamine echo predicts functional recovery after revascularization with ~88% PPV compared to FDG-PET.
Why the study?
The agreement between low-dose dobutamine stress echocardiography (LDDSE) and fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET), and their relative abilities to detect myocardial viability and predict functional recovery after revascularization in myocardial infarction patients, required evaluation.
Observational (n=30)
Single-blind
No
Answers are grounded in this paper and cite their sources.
Shows that low-dose dobutamine echocardiography yields higher specificity than FDG-PET for predicting recovery after revascularization, suggesting greater accuracy for viable myocardium.
The present study investigated the agreement between low-dose dobutamine stress echocardiography (LDDSE) and fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and compared each technique's ability to detect myocardial viability and predict functional recovery in 30 patients. All patients underwent revascularization, followed by echocardiography 5+/-3 months. Of the 390 segments analyzed by echocardiography before revascularization, 110 (28%) had abnormal wall motion. LDDSE showed viability in 66 sites of the 110 dyssynergic segments and 58 of these viable segments recovered their wall motion. With FDG-PET, 78 of the 110 dyssynergic segments were diagnosed as viable and 62 of these showed improvement of the wall motion. The sensitivities for LDDSE and FDG-PET to assess functional recovery were 84% and 90%, respectively; specificities were 80% and 64%, respectively. Positive predictive values for LDDSE and FDG-PET were 88% and 79%; negative predictive values were 75% and 78%, respectively. Both methods had good sensitivity for detecting improvement in regional function after revascularization, but LDDSE had a higher specificity for detecting viability and a better positive predictive value for left ventricular functional recovery.
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Tani et al. (2001) conducted an observational in Myocardial infarction after revascularization (n=30). Low-dose dobutamine stress echocardiography (LDDSE) vs. Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) was evaluated on Prediction of regional functional recovery (wall motion improvement >1 grade) after revascularization (positive predictive value). Low-dose dobutamine stress echocardiography predicted post-revascularization functional recovery with 84% sensitivity, 80% specificity, and 88% PPV compared to 90%, 61%, and 79% for FDG-PET.
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