Detection of functional recovery using low-dose dobutamine and myocardial contrast echocardiography after acute myocardial infarction treated with successful thrombolytic therapy
| Autor: | João Cesar Nunes, Sbano, Jeane Mike, Tsutsui, José Lazaro, Andrade, José, Carlos Nicolau, José Claudio, Meneghetti, José, Franchini Ramires, Wilson, Mathias |
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| Rok vydání: | 2005 |
| Předmět: |
Male
Tomography Emission-Computed Single-Photon Chi-Square Distribution Myocardial Infarction Contrast Media Recovery of Function Middle Aged Myocardial Contraction Sensitivity and Specificity Statistics Nonparametric Echocardiography Predictive Value of Tests Humans Female Thrombolytic Therapy Prospective Studies Aged Echocardiography Stress |
| Zdroj: | Echocardiography (Mount Kisco, N.Y.). 22(6) |
| ISSN: | 0742-2822 |
| Popis: | We studied the value of low-dose dobutamine stress echocardiography (LDDE) and myocardial contrast echocardiography (MCE) in early prediction of left ventricular functional recovery (LVFR) after acute myocardial infarction (AMI) treated with successful thrombolysis.LDDE and MCE using second-harmonic intermittent imaging were performed in first week after AMI. LVFR was defined as an absoluteor =5% increase in ejection fraction, from early to 6 months of follow-up by Technetium-99m-Sestamibi single-photon emission computed tomography.Out of 50 patients studied, 19 evolved with LVFR (group 1) and 31 without LVFR (group 2). Regional dysfunction was detected in 103 (37%) infarcted-related segments in group 1 and in 173 (63%) segments in group 2.Sensitivity, specificity, positive, and negative predictive values and accuracy for detecting LVFR by LDDE were 94.7% (18/19), 87.1% (27/31), 81.8% (18/22), 96.4% (27/28), and 90% (45/50), respectively, and by MCE were 94.7% (18/19), 51.6% (16/31), 54.5% (18/33), 94.1% (16/17), and 68% (34/50). In group 1, functional improvement was observed in 86.9% (53/61) of segments with contractile reserve by LDDE and in 65.8% (52/79) of segments with microvascular perfusion by MCE. In group 2, functional improvement was observed in 78.3% (18/23) of segments with contractile reserve by LDDE and in 25.5% (25/98) of segments with microvascular perfusion by MCE. All segments without perfusion by MCE evolved without functional recovery.LDDE was an accurate predictor of late left ventricular function recovery after AMI, while MCE was sensitive and has a high negative predictive value demonstrating that microvascular perfusion is essential for LVFR. |
| Databáze: | OpenAIRE |
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