Echocardiographic assessment of viable myocardium.
Left ventricular function is one of the most important determinates of long-term prognosis in patients with coronary artery disease. In recent years, it has become apparent that left ventricular dysfunction in patients with coronary artery disease is not always an irreversible process stemming from myocardial necrosis and fibrosis. Myocardial tissue can undergo both a state of potential reversible dysfunction because of prolonged sustained ischemia (hibernating myocardium) or episodes of acute ischemia (stunned myocardium). Revascularization of this tissue may improve regional and global left ventricular function and therefore prognosis. Numerous studies have now firmly established dobutamine echocardiography as a safe, reliable, and accurate imaging modality in the assessment of reversible left ventricular dysfunction. Furthermore, dobutamine echocardiography has been shown to have good sensitivity, specificity, and, more importantly, positive predictive accuracy in identifying both acute and chronic reversible left ventricular dysfunction for risk satisfaction and prognosis.
College of Physicians and Surgeons, Columbia University, St Luke's-Roosevelt Hospital, New York, NY 10025, USA.
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Singh
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Chaudhry
D002316:Cardiotonic Agents; D004176:Dipyridamole; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods; D005080:Exercise Test; D006801:Humans; D017682:Myocardial Stunning / Q000000981:diagnostic imaging*; D005996:Nitroglycerin; D011379:Prognosis; D018570:Risk Assessment; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology
D002316:Cardiotonic Agents; D014665:Vasodilator Agents; D004280:Dobutamine; D004176:Dipyridamole; D005996:Nitroglycerin