[Dobutamine stress echocardiography in patients after an acute myocardial infarct: what is the significance of arterial patency related to the infarct?].
BACKGROUND
Dobutamine stress echocardiography is a very promising technique for assessing myocardial viability, ischemia and prognosis in patients with a recent acute myocardial infarction. Recent studies have shown that the type of perfusion in the infarct-related artery also plays a role in the prognosis of these patients.


OBJECTIVE
To evaluated in patients with non complicated infarction the ability of low-dose and high-dose dobutamine stress echocardiography to assess the presence of both viability and inducible ischemia and correlate the results with the patency of the infarct related artery and the accuracy to predict cardiac events during one year follow-up.


METHODS
Fifty one consecutive in-hospital patients (47 male and four female, mean age 52 +/- 11 years, range 31-75 years) with acute myocardial infarction were evaluated both by dobutamine stress echocardiography and by coronary angiography and followed-up for a mean of 12 +/- 8 months.


RESULTS
With low-doses of dobutamine, the incidence of myocardial viability was 33% and with high-doses, the incidence of residual inducible ischemia was 41%. The patency of infarct-related artery showed significant correlation with score wall motion index for viability and for myocardial ischemia. Twenty four (47%) patients suffered cardiac events. Dobutamine stress echocardiography showed a positive predictive value of 67% and a negative of 70% and identified high and low risk patients.


CONCLUSIONS
Dobutamine stress echocardiography in patients with acute myocardial infarction is a safe and well tolerated test, and provides in a single test useful information regarding viability, ischemia and prognosis.
Fiuza
M
M
UCIM/Medicina IV, Hospital Universitário de Santa Maria, Faculdade de Medicina de Lisboa (FML).
Pereirinha
A
A
Carôla
B
B
Pedro
P
P
Dias
E
E
Conduto
R
R
Dionísio
I
I
da Costa
B B
BB
Calçada
L
L
Amador
M da G
Mda G
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods; D003331:Coronary Vessels / Q000503:physiopathology*; D004280:Dobutamine / Q000008:administration & dosage; D004452:Echocardiography / Q000379:methods* / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000379:methods; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D014654:Vascular Patency
D004280:Dobutamine
Ecocardiografia de sobrecarga com dobutamina nos doentes pós-enfarte agudo do miocárdio: qual a importância da permeabilidade da artéria relacionada com o enfarte?