[Myocardial viability in a single-vessel disease: the role of a dobutamine stress echocardiography].
OBJECTIVE
To investigate a group of patients that have a significant lesion in a single-vessel and to demonstrate whether or not the sensitivity and specificity of a dobutamine stress echocardiography (DSE) was valuable in the evaluation of myocardial viability for these patients.


METHODS
Twenty patients who had undergone percutaneous transluminal coronary angioplasty (PTCA) were studied. This group was evaluated 2 to 7 days (3.65 +/- 1.69) before the procedure and 2 to 5 days (4 +/- 0.80) after the procedure with a DSE. Myocardial viability was assessed three months after the procedure using a two dimensional echocardiogram. Twelve patients underwent PTCA on the left anterior descending artery (LAD), 7 on the right coronary artery (RC) and 1 on the circumflex artery (CX). Only one right coronary artery procedure was not 100% successful.


RESULTS
From the 340 segments that were studied, 99 (29.18%) demonstrated contractile alterations of which 63 were hypokinetic (63.4%), 28 akinetic (28.28%) and 8 dyskinetic (8.08%). In reference to the segments involved, we obtained a sensitivity of 92.59%, specificity of 84.45%, and accuracy of 88.88% for the DSE. The solitary case of PTCA for the circumflex artery demonstrated 100% sensitivity. The LAD demonstrated a sensitivity of 88.58%, specificity of 95% and accuracy of 90.91%. For the RC segments, sensitivity was 91.30%, specificity 83.33% and accuracy 88.71%. All dyskinetic segments were unviable. The DSE predicted a 91.48% recovery rate for the 63 hypokinetic segments.


CONCLUSIONS
The DSE is an effective test for evaluating myocardial viability in patients with a significant single-vessel disease.
Castier
Márcia Bueno
MB
ECOR Serviço de Ecocardiografia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ. mcastier@cardiol.br
Carrinho
José Raul Alves
JR
Carrinho
Márcia Alves
MA
Albanesi Filho
Francisco Manes
FM
Moraes
Alvaro Villela de
AV
Morcerf
Fernando Portugal
FP
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002316:Cardiotonic Agents; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D004280:Dobutamine; D025401:Echocardiography, Stress / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014022:Tissue Survival / Q000502:physiology; D016896:Treatment Outcome
D002316:Cardiotonic Agents; D004280:Dobutamine