An assessment of dobutamine echocardiography and end-diastolic wall thickness for predicting post-revascularization functional recovery in patients with chronic coronary artery disease.
OBJECTIVE
This study investigated the functional outcome of wall-thinned, akinetic myocardium after revascularization and evaluated the accuracy of dobutamine echocardiography in predicting post-revascularization functional recovery with the assessment of end-diastolic wall thickness in chronic ischaemic patients.


RESULTS
Fifty-three patients underwent dobutamine echocardiography before coronary revascularization. End-diastolic wall thickness was also evaluated before and after revascularization. The sensitivity and specificity of dobutamine echocardiography to predict postrevascularization functional recovery were 69% and 100% in 58 akinetic/dyskinetic segments, and 86% and 57% in 96 hypokinetic segments. Of 19 akinetic/dyskinetic segments with a preserved end-diastolic wall thickness, 17 (89%) showed functional recovery after revascularization, and dobutamine detected 14 (83%) of these 17 segments. Of 39 akinetic/dyskinetic segments with a thinned end-diastolic wall thickness, 15 (38%) achieved functional recovery, whereas dobutamine echocardiography detected recovery in only eight (53%). Further, of these 15 viable, Wall-thinned segments, 12 (80%) showed an increased end-diastolic wall thickness after revascularization (mean +/- SD were from 5.6 +/- 0.7 mm at baseline to 7.4 +/- 1.3 mm and 9.7 +/- 1.4 mm after 1 week and after 3 months, respectively), and only 5 (42%) of these responded to dobutamine.


CONCLUSIONS
Dobutamine echocardiography showed a lessened sensitivity to predict post-revascularization functional recovery in akinetic/dyskinetic segments with a thinned end-diastolic wall thickness that subsequently increased in size.
Furukawa
T
T
First Department of Internal Medicine, Shiga University of Medical Science, Japan.
Haque
T
T
Takahashi
M
M
Kinoshita
M
M
D000328:Adult; D000368:Aged; D002306:Cardiac Volume / Q000502:physiology*; D002316:Cardiotonic Agents; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D003971:Diastole / Q000502:physiology*; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology
D002316:Cardiotonic Agents; D004280:Dobutamine