Enoximone very low-dose dobutamine stress echocardiography: a new test for detecting viability in severe myocardial dysfunction after acute myocardial infarction.
Relying on the synergistic action on contractility of enoximone and dobutamine when concomitantly infused, 25 patients with their first acute Q-wave anterior myocardial infarctions underwent conventional low-dose dobutamine echocardiography (LDE) and enoximone very-LDE to assess myocardial viability in severely dysfunctioning areas. Images were recorded at peak of pharmacodynamic effect of drugs and 4 months after revascularization. At peak-dose stage of LDE and enoximone very-LDE the regional infarct zone wall-motion score significantly decreased from the basal value of 25.6 +/- 2.9 to 16 +/- 6.0 (P <.001) and to 14.5 +/- 5.2 (P <.001), respectively. A high correlation was found by comparing the wall-motion score of each patient calculated at peak effect of combined drug administration with follow-up values (r(s) = 0.9). Enoximone very-LDE has proven to be a new test useful to evaluate viability in asynergic segments especially when the results of conventional tests are questionable.
Mangieri
Enrico
E
II Department of Cardiology, Institute of Heart and Great Vessels Attilio Reale, University of Rome La Sapienza, Italy.
Tanzilli
Gaetano
G
Barillà
Francesco
F
Pannitteri
Gaetano
G
Acconcia
Maria Cristina
MC
Mezzanotte
Roberto
R
Donati
Roberto
R
Comito
Cosimo
C
Critelli
Giuseppe
G
D000328:Adult; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002316:Cardiotonic Agents / Q000494:pharmacology; D004280:Dobutamine / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D020820:Dyskinesias / Q000175:diagnosis / Q000503:physiopathology; D025401:Echocardiography, Stress; D017335:Enoximone / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects / Q000502:physiology; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013268:Stimulation, Chemical; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology
D002316:Cardiotonic Agents; D004280:Dobutamine; D017335:Enoximone