Knowledge of perfusion and contractile reserve improves the predictive value of recovery of regional myocardial function postrevascularization: A study using the combination of myocardial contrast echocardiography and dobutamine echocardiography

Meza, Mario F., Ramee, Stephen, Collins, Tyrone, Stapleton, Dwight, Milani, Richard V., Murgo, Joseph P. and Cheirif, Jorge (1997) Knowledge of perfusion and contractile reserve improves the predictive value of recovery of regional myocardial function postrevascularization: A study using the combination of myocardial contrast echocardiography and dobutamine echocardiography. Circulation, 96 10: 3459-3465. doi:10.1161/​01.CIR.96.10.3459


Author Meza, Mario F.
Ramee, Stephen
Collins, Tyrone
Stapleton, Dwight
Milani, Richard V.
Murgo, Joseph P.
Cheirif, Jorge
Title Knowledge of perfusion and contractile reserve improves the predictive value of recovery of regional myocardial function postrevascularization: A study using the combination of myocardial contrast echocardiography and dobutamine echocardiography
Journal name Circulation   Check publisher's open access policy
ISSN 0009-7322
1524-4539
Publication date 1997-11
Sub-type Article (original research)
DOI 10.1161/​01.CIR.96.10.3459
Volume 96
Issue 10
Start page 3459
End page 3465
Total pages 7
Place of publication Baltimore, MD, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
Background This study was designed to determine the value of myocardial contrast echocardiography (MCE) and dobutamine echocardiography (DE), alone or in combination, in predicting functional recovery in patients with resting wall motion abnormalities due to CAD. MCE and DE have been independently shown to be useful in detecting myocardial viability in the post–myocardial infarction setting.
Methods and Results Thirty-nine patients with significant coronary artery disease and resting wall motion abnormalities underwent DE (2.5 to 20 μg · kg−1 · min−1) and wall motion analysis (16-segment model). MCE was performed with selective intracoronary injections of sonicated meglumine (2 cm3). Myocardial viability was defined as presence of contrast effect by MCE and contractile reserve or an ischemic response by DE. Functional recovery (improvement in wall motion) was assessed after revascularization (percutaneous transluminal coronary angioplasty, n=20; coronary artery bypass surgery, n=19). When the two groups of patients were analyzed, MCE was associated with excellent sensitivities (84%) yet poor specificities (19% to 26%); DE had lower sensitivities (79% to 80%) but also poor specificities (30% to 36%). The combination of both was associated with excellent sensitivities (90% to 93%) and modest specificities (48% to 50%) for predicting functional recovery. A biphasic response with DE was infrequent (14% to 42%) but highly specific of functional recovery (84% to 94%). MCE had an excellent negative predictive value for functional recovery (83%).
Conclusions The prediction of functional recovery post-revascularization can be enhanced by combining MCE and DE.
Keyword Perfusion
Contractility
Myocardium
Revascularization
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 09:51:05 EST