Does resting echocardiography predict a positive response to subsequent low-dose dobutamine stress echocardiography in patients with ischaemic cardiomyopathy?
| Autor: | Wail Nammas, Zainab Abdel-Salam |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Cardiotonic Agents Myocardial Ischemia Ischaemic cardiomyopathy Diagnosis Differential Predictive Value of Tests Dobutamine Internal medicine Stress Echocardiography medicine Humans In patient Myocardial infarction Aged Retrospective Studies Ejection fraction Dose-Response Relationship Drug business.industry Low dose dobutamine Stroke Volume General Medicine Middle Aged Prognosis medicine.disease Echocardiography Doppler Deceleration time Positive response Cardiology Female Cardiomyopathies Cardiology and Cardiovascular Medicine business Echocardiography Stress Follow-Up Studies |
| Zdroj: | Acta Cardiologica. 67:693-699 |
| ISSN: | 0373-7934 0001-5385 |
| DOI: | 10.1080/ac.67.6.2184672 |
| Popis: | dobutamine stress echocardiography (DSE) in patients with ischaemic cardiomyopathy. We explored the accuracy of resting echocardiographic and tissue Doppler parameters to predict a positive response by low-doseWe enrolled 100 consecutive patients with prior myocardial infarction, and a left ventricular ejection fraction (LVEF)35%. They underwent resting echocardiographic assessment of LVEF, wall motion score index (WMSI), mitral E and A peak velocities, E/A ratio, E peak deceleration time, isovolumetric relaxation time (IVRT), early mitral annular diastolic velocity (e'), and E/e' ratio. Subsequently, they underwent low-dose DSE for assessment of myocardial viability. The presence of viability was defined by improvement of the regional wall motion score byor =1 grade inor = 5 myocardial segments, withor = 20% reduction in WMSI compared with baseline evaluation. Thirty-six patients had a negative response to DSE (group 1); 64 had a positive response (group II). Resting LVEF was higher, and resting WMSI lower in group II versus group I; E peak deceleration time and IVRT shorter in group I (P0.05 for all). Multivariable regression analysis identified LVEF, WMSI, and IVRT as the independent predictors of a positive response to DSE. A cutoff value of LVEF of25% predicted viability with a sensitivity of 85.9%, specificity 80.6%; WMSI ofor = 2.6 had a sensitivity of 85.7%, specificity 61.1%; IVRT of60 msec had a sensitivity of 93.7%, specificity 47.2%.Resting LVEF25%, WMSI2.6, and IVRT60 msec predicted viability with a high sensitivity; however, with the exception of LVEF, specificity was quite low. |
| Databáze: | OpenAIRE |
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