title: Relationship between late potentials and myocardial viability assessed by dobutamine echocardiography in the early postinfarction period.
abstract: BACKGROUND
  In the postmyocardial infarction period, late potentials (LPs) are a sensitive marker for the occurrence of sustained ventricular tachycardia and ventricular fibrillation. The relationship between positive signal-averaged electrocardiogram (SAECG) and myocardial viability remains controversial. The aim of the present study was to assess prospectively the possible relationship between LPs and myocardial viability detected by dobutamine stress echocardiography (DSE) in the early period after myocardial infarction (AMI), before hospital discharge.
  
  
  METHODS
  Ninety-nine patients with AMI were included prospectively in the study. The mean age was 58 +/- 11 years, 17 were women and 82 were men. All patients had SAEG and DSE, and 94 had coronary angiography before hospital discharge.
  
  
  RESULTS
  In the overall population, presence of viability was demonstrated in fewer patients with LPs [37 of 70 (52%)] than absence of viability [18 of 29 (62%)] but the difference did not reach statistical significance. In the subgroup of patients with left ventricular ejection fraction (LVEF) lower than 40%, at higher risk of arrhythmias, the presence of viability was associated with the absence of LPs: 80% of the patients without LPs had viability by DSE (P < 0.01) and only 35% of patients with LPs had viability by DSE (not significant).
  
  
  CONCLUSIONS
  In patients with an acute myocardial infarction and with low ejection fraction (<40%), the absence of LPs is related to the presence of viable myocardium as assessed by DSE early after the acute event. These data also suggest that myocardial viability is not the substrate for LPs in this population.
authors: Cardiology Department, Academisch Ziekenhuis, Vrije Universiteit Brussel, Belgium. cardiohbw@swing.be
authors: Bernard
authors: B
authors: Cosyns
authors: Elif
authors: E
authors: Akseki
authors: Guy
authors: G
authors: Van Camp
authors: Danny
authors: D
authors: Schoors
authors: Isabelle
authors: I
authors: Liebens
authors: Danièle
authors: D
authors: Plein
authors: Jean-Luc
authors: JL
authors: Vandenbossche
authors: Philippe
authors: P
authors: Franken
mesh_terms: D000318:Adrenergic beta-Agonists; D000368:Aged; D004280:Dobutamine; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D018570:Risk Assessment; D013318:Stroke Volume
chemical_list: D000318:Adrenergic beta-Agonists; D004280:Dobutamine