Post-extrasystolic potentiation recruits incremental contractile reserve of dyssynergic myocardium during dobutamine stress testing: evidence by pulsed wave tissue Doppler imaging.
Dobutamine stress echocardiography is an established diagnostic method for the detection of myocardial viability in patients with severe left ventricular dysfunction([1]). The presence of viable myocardium identifies patients who will benefit from coronary revascularization, by improving both functional capacity and long-term survival. Occasionally, dobutamine infusion has been combined with other stressors, such as post-extrasystolic potentiation, in order to improve accuracy. The contractile reserve after combined dobutamine infusion and post-extrasystolic potentiation can be quantified by pulsed wave tissue Doppler imaging. We describe a patient with severe left ventricular dysfunction, in which pulsed wave tissue Doppler imaging allowed to demonstrate that post-extrasystolic potentiation superimposed on dobutamine infusion is able to further recruit contractile reserve, as compared to dobutamine infusion alone. A nuclear scan assessing glucose utilization was used as a reference.
Rambaldi
R
R
Erasmus Medical Center, Rotterdam, The Netherlands.
Poldermans
D
D
Bax
J J
JJ
Bountioukos
M
M
Roelandt
J R T C
JR
D000368:Aged; D005117:Cardiac Complexes, Premature / Q000175:diagnosis* / Q000503:physiopathology*; D018619:Echocardiography, Doppler, Pulsed; D025401:Echocardiography, Stress; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology*; D009206:Myocardium / Q000473:pathology*; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18