title: Enoximone very low-dose dobutamine stress echocardiography: a new test for detecting viability in severe myocardial dysfunction after acute myocardial infarction.
abstract: 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.
authors.affiliation: II Department of Cardiology, Institute of Heart and Great Vessels Attilio Reale, University of Rome La Sapienza, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Mangieri
authors.forename: Gaetano
authors.initials: G
authors.lastname: Tanzilli
authors.forename: Francesco
authors.initials: F
authors.lastname: Barillà
authors.forename: Gaetano
authors.initials: G
authors.lastname: Pannitteri
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Acconcia
authors.forename: Roberto
authors.initials: R
authors.lastname: Mezzanotte
authors.forename: Roberto
authors.initials: R
authors.lastname: Donati
authors.forename: Cosimo
authors.initials: C
authors.lastname: Comito
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Critelli
mesh_terms: 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
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine; D017335:Enoximone