Viability of Q-wave infarcted myocardium with restored positive and persistent negative T waves after optimal revascularization compared with dobutamine stress echocardiography.
To clarify the clinical difference in viability of myocardium with negative and positive T waves in Q-wave anterior or anteroseptal myocardial infarction, we performed low-dose dobutamine stress echocardiography in 17 patients with negative T waves and in 13 patients with positive T waves with optimal revascularization of infarct-related arteries in the chronic phase of infarction. At baseline the wall motion score (WMS) of the negative and positive T groups was 25.8 +/- 3.0 and 22.3 +/- 2.2 points (p <0.05), respectively. At peak stress WMS in each group was 27.2 +/- 4.2 and 19.8 +/- 2.4 points (p <0.0001), respectively. With dobutamine stress WMS in the positive T group was more decreased than that of the negative T group (p <0.0001). We conclude that the restored positive T waves in Q-wave myocardial infarction indicate a significantly greater amount of viable myocardium than the negative T waves, showing better regional wall motion improvement with low-dose dobutamine stress.
Watanabe
S
S
Department of Cardiology, Hitachi General Hospital, Ibaraki, Japan.
Kawamura
Y
Y
Watanabe
Y
Y
Tanaka
K
K
Tanaka
K
K
Takei
Y
Y
Ejiri
N
N
Shimada
K
K
D000368:Aged; D002316:Cardiotonic Agents; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005080:Exercise Test / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000201:enzymology / Q000503:physiopathology / Q000628:therapy*; D009204:Myocardial Revascularization / Q000379:methods; D011379:Prognosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D002316:Cardiotonic Agents; D004280:Dobutamine; D003402:Creatine Kinase