Prognostic role of dobutamine stress echocardiography in myocardial viability.
OBJECTIVE
The aim of this review is to provide a perspective on the role of dobutamine stress echocardiography to evaluate myocardial viability and assess prognosis in patients with ischemic left ventricular dysfunction.


RESULTS
Pooled analysis of currently available data demonstrates that dobutamine stress echocardiography provides useful information on recovery of dysfunctional but viable myocardium and prognosis. In fact, improvement of long-term prognosis may be the ultimate clinical challenge in the management of patients with ischemic left ventricular dysfunction. Dobutamine stress echocardiography can be used to assess residual ischemia and contractile reserve, which are significant determinants of prognosis. Additionally, other echocardiographic variables, such as end-diastolic wall thickness, end-systolic volume, and extent of viability, affect outcome after revascularization in patients with ischemic cardiomyopathy.


CONCLUSIONS
Dobutamine stress echocardiography provides information on myocardial ischemia, contractile reserve, and other prognostically relevant parameters in patients with ischemic left ventricular dysfunction. This information can be used to select the optimal treatment strategy for these patients and to estimate and improve clinical outcome.
Schinkel
Arend F L
AF
Thoraxcenter, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
Poldermans
Don
D
Elhendy
Abdou
A
Bax
Jeroen J
JJ
D009202:Cardiomyopathies / Q000175:diagnosis* / Q000503:physiopathology; D025401:Echocardiography, Stress / Q000379:methods*; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D009200:Myocardial Contraction / Q000502:physiology; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000503:physiopathology; D014022:Tissue Survival / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology