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.
Department of Medicine, Division of Cardiology, Söder Hospital, Stockholm, Sweden. Bassem.Samad@kedklin.sos.sll.se
B A
BA
Samad
M
M
Frick
J
J
Höjer
M J
MJ
Urstad
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