Prediction of functional recovery in patients with myocardial infarction after revascularization--comparison of low-dose dobutamine stress echocardiography with fluorine-18 fluorodeoxyglucose positron emission tomography.
The present study investigated the agreement between low-dose dobutamine stress echocardiography (LDDSE) and fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and compared each technique's ability to detect myocardial viability and predict functional recovery in 30 patients. All patients underwent revascularization, followed by echocardiography 5+/-3 months. Of the 390 segments analyzed by echocardiography before revascularization, 110 (28%) had abnormal wall motion. LDDSE showed viability in 66 sites of the 110 dyssynergic segments and 58 of these viable segments recovered their wall motion. With FDG-PET, 78 of the 110 dyssynergic segments were diagnosed as viable and 62 of these showed improvement of the wall motion. The sensitivities for LDDSE and FDG-PET to assess functional recovery were 84% and 90%, respectively; specificities were 80% and 64%, respectively. Positive predictive values for LDDSE and FDG-PET were 88% and 79%; negative predictive values were 75% and 78%, respectively. Both methods had good sensitivity for detecting improvement in regional function after revascularization, but LDDSE had a higher specificity for detecting viability and a better positive predictive value for left ventricular functional recovery.
First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan.
T
T
Tani
M
M
Teragaki
H
H
Watanabe
T
T
Muro
H
H
Yamagishi
K
K
Akioka
K
K
Takeuchi
J
J
Yoshikawa
D000368:Aged; D002470:Cell Survival; D004280:Dobutamine; D004452:Echocardiography / Q000592:standards; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D009204:Myocardial Revascularization; D009206:Myocardium / Q000166:cytology; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed / Q000592:standards; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left
D019788:Fluorodeoxyglucose F18; D004280:Dobutamine