Dobutamine stress echocardiography is highly accurate for the prediction of contractile reserve in the early postoperative period, but may underestimate late recovery in contractile reserve after revascularization of the hibernating myocardium.
OBJECTIVE
We sought to investigate the accuracy of dobutamine stress echocardiography to predict the degree and timing of recovery in resting function and contractile reserve (CR) after revascularization of the hibernating myocardium.


METHODS
In all, 24 patients with ischemic cardiomyopathy (ejection fraction < 40%) underwent dobutamine stress echocardiography 1 week before and 6 weeks, 3 months, and 6 months after coronary artery bypass grafting.


RESULTS
Recovery rates at 6 weeks, 3 months, and 6 months postoperation were 21%, 33%, and 45% (P < .01) for resting function and 55%, 65%, and 74% (P < .01) for CR. Positive and negative predictive values for recovery of resting function and CR at 6 months postrevascularization were 66% vs 97% (P < .001) and 78% vs 48% (P < .001), respectively. Positive and negative predictive values were both high for recovery of CR at 6 weeks postrevascularization (89% and 78%).


CONCLUSIONS
Dobutamine stress echocardiography can predict early recovery in CR postrevascularization with an excellent accuracy but may underestimate the degree of late recovery in CR.
Zaglavara
Theodora
T
Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
Karvounis
Haralambos I
HI
Haaverstad
Rune
R
Pillay
Thaseegaran M
TM
Hamilton
John R L
JR
Hasan
Asif
A
Parharidis
Georgios E
GE
Louridas
Georgios E
GE
Dark
John H
JH
Kenny
Antoinette
A
D009202:Cardiomyopathies / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D001026:Coronary Artery Bypass; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D017682:Myocardial Stunning / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D011379:Prognosis; D020127:Recovery of Function; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control
D014665:Vasodilator Agents; D004280:Dobutamine