title: Strain rate dobutamine echocardiography for prediction of recovery after revascularization in patients with ischemic left ventricular dysfunction.
abstract: BACKGROUND
  The purpose of the present study was to assess the accuracy of quantitative segmental analysis by strain rate imaging (SRI) technique during dobutamine test for detecting myocardial recovery after revascularization in patients with chronic ischemic regional left ventricular (LV) dysfunction and compare results with those of 2-dimensional echocardiography (2D) and tissue Doppler imaging (TDI) as well as rest-4 hours-24 hours redistribution thallium SPECT (Tl SPECT).
  
  
  RESULTS
  Forty-one patients with chronic ischemic regional LV dysfunction (EF 29 +/- 8%) underwent dobutamine 2D/TDI/SRI and Tl SPECT before and after myocardial revascularization. The sensitivity, specificity, and accuracy for the recovery of regional LV function were 73%, 81%, and 77% for dobutamine 2D; 77%, 82%, and 80% for dobutamine TDI; 86%, 88%, and 85% for dobutamine SRI; and 94%, 76%, and 84% for Tl tomography. The area under the ROC curve (AUC), which reflects the overall performance for the prediction of recovery, was 0.79 for systolic-SR, 0.81 for Tl SPECT, 0.83 for postsystolic strain, and 0.87 for isovolumic-SR. If both systolic and postsystolic SRI indexes were combined with Tl SPECT, the AUC was improved to 0.94.
  
  
  CONCLUSIONS
  Dobutamine SRI is more accurate than TDI in identifying hibernating myocardium. Systo-diastolic values obtained using dobutamine SRI echocardiography and values derived from nuclear perfusion techniques may be complementary in assessing myocardial viability.
authors: La Sapienza University, Rome, Italy.
authors: Antonio
authors: A
authors: Vitarelli
authors: Teresa
authors: T
authors: Montesano
authors: Carlo
authors: C
authors: Gaudio
authors: Ysabel
authors: Y
authors: Conde
authors: Ester
authors: E
authors: Cimino
authors: Ilaria
authors: I
authors: D'angeli
authors: Simona
authors: S
authors: D'orazio
authors: Simona
authors: S
authors: Stellato
authors: Daniela
authors: D
authors: Battaglia
authors: Viviana
authors: V
authors: Padella
authors: Fiorella
authors: F
authors: Caranci
authors: Massimo
authors: M
authors: Ciancamerla
authors: Angelo Domenico
authors: AD
authors: Di Nicola
authors: Giuseppe
authors: G
authors: Ronga