[Detection of hibernating myocardium in patients with myocardial infarction by low-dose dobutamine echocardiography: comparison with thallium-201 scintigraphy with reinjection].
The identification of hibernating myocardium is important for selecting patients who will benefit from coronary revascularization. The relationship between echocardiographic and radioisotopic markers of hibernating myocardium and postrevascularization recovery of myocardial function was investigated in 21 patients who underwent successful revascularization. Each patient underwent low-dose dobutamine stress echocardiography and thallium-201 (201Tl) scintigraphy with reinjection before revascularization. The presence of contractile reserve in dobutamine stress echocardiography and Tl uptake in 201Tl scintigraphy with reinjection were defined as markers of hibernating myocardium. Follow-up echocardiograms were evaluated for improved regional wall motion in all patients at a mean of 8.6 months after revascularization. Sensitivity, specificity, and positive and negative predictive values of low-dose dobutamine stress echocardiography for indicating recovery of function after revascularization were 75.0%, 77.8%, 81.8%, and 70.0%, respectively. Sensitivity, specificity, and positive and negative predictive values of 201Tl scintigraphy with reinjection for indicating recovery of function after revascularization were 91.7%, 55.6%, 73.3%, and 83.3%, respectively. There were no statistical differences between low-dose dobutamine echocardiography and 201Tl scintigraphy in predicting postrevascularization recovery of function patients with hibernating myocardium.
Takagi
T
T
Department of Cardiology, Kobe General Hospital.
Yoshikawa
J
J
Yoshida
K
K
Akasaka
T
T
Honda
Y
Y
Yonezawa
Y
Y
Shakudo
M
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D004280:Dobutamine / Q000008:administration & dosage; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007275:Injections, Intravenous / Q000379:methods; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000150:complications* / Q000601:surgery / Q000628:therapy; D017682:Myocardial Stunning / Q000000981:diagnostic imaging* / Q000209:etiology; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes / Q000008:administration & dosage
D013794:Thallium Radioisotopes; D004280:Dobutamine