Early low-dose dobutamine echocardiography predicts late functional recovery after thrombolyzed acute myocardial infarction.
BACKGROUND
This study was undertaken to evaluate the ability of predischarge low-dose dobutamine echocardiography to predict late left ventricular functional recovery after thrombolyzed acute myocardial infarction.


RESULTS
Low-dose dobutamine echocardiography was performed in 54 patients 4 +/- 2 days after acute myocardial infarction treated with thrombolysis. Follow-up resting echocardiography was carried out in 49 of these patients at a mean of 18 +/- 6 months later. Viability was defined as recovery of myocardial function at follow-up, expressed as an improvement of wall motion of at least 1 grade or more in at least 2 contiguous infarct zone segments. In 24 of the 49 patients (group I), wall motion at follow-up improved in comparison with the early resting echocardiographic study (1.72 +/- 0.29 vs 1.37 +/- 0.34, P <.001). In the remaining 25 patients (group II), no wall motion enhancement was seen at follow-up (1.57 +/- 0.38 vs 1.58 +/- 0.36, NS). In 22 of the 24 patients in group I, early low-dose dobutamine echocardiography showed improvement in the wall motion score index compared with baseline resting measurements (1.72 +/- 0.29 vs 1.44 +/- 0.24, P <.001). The positive and negative predictive value of early low-dose dobutamine echocardiography to predict functional recovery was 76% and 92%, respectively.


CONCLUSIONS
Predischarge low-dose dobutamine echocardiography is an accurate tool for detecting viable myocardium and predicting late left ventricular recovery after acute myocardial infarction treated with thrombolysis.
Samad
B A
BA
Department of Medicine, Division of Cardiology, Söder Hospital, Stockholm, Sweden. Bassem.Samad@kedklin.sos.sll.se
Frick
M
M
Höjer
J
J
Urstad
M J
MJ
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology / Q000601:surgery / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004280:Dobutamine / Q000008:administration & dosage; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000209:etiology / Q000601:surgery / Q000628:therapy; D011237:Predictive Value of Tests; D020127:Recovery of Function / Q000502:physiology*; D012008:Recurrence; D012146:Rest / Q000502:physiology; D015912:Thrombolytic Therapy; D014022:Tissue Survival; D016277:Ventricular Function, Left / Q000502:physiology*
D000318:Adrenergic beta-Agonists; D004280:Dobutamine