Prediction of viability by pulsed-wave Doppler tissue sampling of asynergic myocardium during low-dose dobutamine challenge
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Date
2000
Journal Title
Journal ISSN
Volume Title
Publisher
ELSEVIER SCI IRELAND LTD
Access Rights
info:eu-repo/semantics/closedAccess
Abstract
Dobutamine stress echocardiography is widely used to predict reversible left ventricular dysfunction, but evaluation with this method is subjective. Pulsed-wave tissue Doppler imaging is a new technique that allows to obtain quantitative data on wall motion velocities of different myocardial segments through sample-volume placement. Therefore, this tool in combination with DSE may be suitable for identifying viability in asynergic myocardium. To evaluate this, in 40 patients (mean age 57+/-9) with resting dyssynergy (akinesis in 52, hypokinesis in 30) baseline wall motion scores and tissue Doppler variables were collected before and after 5 min infusion of 10 mu g/kg per min dobutamine. Forty-six of 82 segments were classified as viable (a reduction in segmental score of at least one grade) according to follow-up echocardiography that was performed 4 weeks after revascularization. While myocardial S velocity percent increase in viable segments was 45+/-10, the increase was 25+/-12 in necrotic segments (n=36) during 10 mu g dobutamine infusion (P=0.0001). Assuming 35% as a cut-off for viability the increase in S velocities by DSE yielded an 89% sensitivity and 86% specificity for predicting post-revascularization functional recovery. In conclusion, pulsed-wave tissue Doppler imaging of asynergic myocardium during dobutamine stress echocardiography can identify the viability quantitatively. (C) 2000 Elsevier Science Ireland Ltd. All nights reserved.
Description
Keywords
tissue Doppler, viability, dobutamine stress test
Journal or Series
INTERNATIONAL JOURNAL OF CARDIOLOGY
WoS Q Value
Q3
Scopus Q Value
Q1
Volume
74
Issue
2.Mar
