Diastolic indexes during dobutamine stress echocardiography in patients early after myocardial infarction.
The aim of this study was to determine whether Doppler parameters assessed during dobutamine stress echocardiography in the early phase after myocardial infarction could discriminate patients with residual ischemia from those without. Thirty-six patients after a recent myocardial infarction with and without residual ischemia underwent dobutamine stress echocardiography, adenosine sestamibi scintigraphy, and coronary angiography within 2 weeks after the acute event. The only diastolic Doppler parameter discriminating the two groups was the isovolumic relaxation time (IVRT) measured at the peak of the dobutamine infusion. It became shorter in both groups but significantly more in patients without than in those with residual ischemia despite a larger increase in heart rate in the latter group. IVRT at rest was 78 +/- 18 msec and decreased with high-dose dobutamine to 54 +/- 11 msec in the control group and to 69 +/- 16 msec in the ischemic group (p < 0.01). In addition, the rate-corrected IVRT (IVRTc) was calculated: IVRTc = IVRT/sqrtRR. The value of IVRTc = 80 at peak dobutamine infusion is able to discriminate patients with residual ischemia from those without with a sensitivity of 80% and a specificity of 70%.
Dabrowska-Kugacka
A
A
Department of Cardiology, University Hospital of Antwerp, Edegem, Belgium.
Claeys
M J
MJ
Rademakers
F E
FE
D000241:Adenosine / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D006328:Cardiac Catheterization; D003971:Diastole; D004280:Dobutamine; D015150:Echocardiography, Doppler; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011877:Radionuclide Imaging; D017256:Technetium Tc 99m Sestamibi; D013997:Time Factors
D004280:Dobutamine; D017256:Technetium Tc 99m Sestamibi; D000241:Adenosine