Low-dose dobutamine stress echocardiography demonstrated 90% sensitivity and 80% specificity for predicting functional recovery of viable myocardium after acute myocardial infarction.
Cohort (n=30)
Single-blind
No
Does low-dose dobutamine stress echocardiography accurately predict functional recovery of viable myocardium in patients with acute myocardial infarction compared to nuclear imaging modalities?
BACKGROUND: Low-dose dobutamine stress echocardiography (LDDE) has become a useful and safe method for identifying hibernating or stunned myocardium and for predicting improvement in wall motion after coronary revascularization. METHODS AND RESULTS: In the present study, fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET), rest-redistribution thallium-201 ((201)Tl) single-photon emission computed tomography (RR-Tl SPECT), (123)I-15-(p-iodophenyl)-3-(R,S)-methyl pentadecanoic acid (BMIPP) and LDDE were performed in 30 patients with acute myocardial infarction (AMI) at 10+/-3 days after the onset of AMI. Also, exercise (201)Tl reinjection SPECT (RI-Tl SPECT) was performed at 14+/-2 days. Follow-up echocardiography was performed 5+/-3 months later in all patients after interventional therapy for the assessment of functional recovery. Of the 390 segments analyzed by echocardiography, 110 (28%) had abnormal wall motion. There were no significant differences between RR-Tl SPECT and LDDE in sensitivity, specificity, positive predictive value and negative predictive value using the chi(2)-test; however, in akinetic segments, there was a significant difference in sensitivity. Among FDG-PET, RI-Tl SPECT, BMIPP and LDDE, there were significant differences in 3 variables. In akinetic segments, LDDE is superior to RR-Tl SPECT in sensitivity and to FDG-PET in specificity. In hypokinetic segments, LDDE is superior to RI-Tl SPECT and BMIPP in sensitivity, and to FDG-PET and BMIPP in specificity. CONCLUSIONS: LDDE could detect functional recovery of viable myocardium in the early period of AMI and can be performed easily and safely.
Tani et al. (2004) conducted a cohort in Acute myocardial infarction (n=30). Low-dose dobutamine stress echocardiography (LDDE) vs. FDG-PET, RR-Tl SPECT, RI-Tl SPECT, and BMIPP SPECT was evaluated on Sensitivity for predicting functional recovery. Low-dose dobutamine stress echocardiography demonstrated 90% sensitivity and 80% specificity for predicting functional recovery of viable myocardium after acute myocardial infarction.