Comparison of real-time contrast echocardiography and low-dose dobutamine stress echocardiography in predicting the left ventricular functional recovery in patients after acute myocardial infarction under different therapeutic intervention. International journal of cardiology. [Int J Cardiol] Journal article | | Title | Comparison of real-time contrast echocardiography and low-dose dobutamine stress echocardiography in predicting the left ventricular functional recovery in patients after acute myocardial infarction under different therapeutic intervention. | | Author(s) | Huang WC, Chiou KR, Liu CP, Lin SL, Lee D, Mar GY, Hsiao SH, Kung MH, Chiou CW, Lin TW | | Institution | Division of Cardiology, Kaohsiung Veterans General Hospital, No.386, Dar-Chung First Road, Kaohsiung City, Taiwan, ROC. | | Source | Int J Cardiol 2005 Sep 15; 104(1):81-91. | | MeSH | Aged
Angioplasty, Transluminal, Percutaneous Coronary
Comparative Study
Coronary Angiography
Coronary Stenosis
Dose-Response Relationship, Drug
Echocardiography
Echocardiography, Stress
Female
Follow-Up Studies
Heart Ventricles
Humans
Male
Middle Aged
Myocardial Contraction
Myocardial Infarction
Observer Variation
Predictive Value of Tests
Prospective Studies
Research Support, Non-U.S. Gov't
Sensitivity and Specificity
Thrombolytic Therapy
Ventricular Function, Left
| | Abstract | BACKGROUND: Early prediction of left ventricular (LV) functional recovery after acute myocardial infarction (AMI) remains challenging. This prospective study aims to compare real-time myocardial contrast echocardiography (MCE) with low-dose dobutamine stress echocardiography (LDDSE) in predicting the LV functional recovery in patients after AMI who underwent different therapeutic interventions.
METHODS: Ninety-two patients with AMI were divided into 3 groups: primary coronary intervention group (n=34), thrombolysis group (n=30) and conservative therapy group (n=28). MCE was performed 2.3+/-0.7 days after chest pain onset. LDDSE was done within 2 days of MCE study. Follow-up echocardiography was performed 4 months later.
RESULTS: Patients treated by primary coronary intervention or thrombolysis had significantly lower regional perfusion score (0.65+/-0.53 vs. 1.01+/-0.49, p=0.008; 0.78+/-0.55 vs. 1.01+/-0.49, p=0.03), better contractile reserve (regional dobutamine Deltawall motion score -1.12+/-0.39 vs. -0.80+/-0.43, p=0.01; -0.99+/-0.50 vs. -0.80+/-0.43, p=0.08) and LV function recovery (regional Deltawall motion score -1.67+/-0.53 vs. -1.02+/-0.46, p=0.003; -1.42+/-0.58 vs. -1.02+/-0.46, p=0.03) than those of conservative therapy group. MCE and LDDSE showed good concordance for predicting LV functional recovery (kappa=0.63, p<0.001). Perfusion score index had a good correlation with LV functional recovery (r=-0.75, p<0.001).
CONCLUSIONS: This study demonstrates that perfusion score index obtained from real-time MCE is comparable to LDDSE in predicting the LV functional recovery even under different therapeutic interventions. Revascularization results in better preservation of myocardial microvascular integrity, regional contractile reserve and LV functional recovery. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 16137515 |
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