title: Prediction of myocardial recovery by dobutamine magnetic resonance imaging and delayed enhancement early after reperfused acute myocardial infarction.
abstract: The purpose was to study dobutamine magnetic resonance cine imaging (DOB-MRI) and delayed myocardial contrast enhancement (DE) early after reperfused acute myocardial infarction (AMI) for the predicion of segmental myocardial recovery and to find the optimal dose of dobutamine. Fifty patients (56+/-12 years, 42 males) with reperfused AMI underwent DOB-MRI and DE studies 3.5 (1-19) days after reperfusion. In DOB-MRI systolic wall thickening (SWT) was measured in 18 segments at rest and during dobutamine at 5, 10 and 20 microg*kg(-1)*min(-1). Dysfunctional segments were identified and the extent of DE was measured for each segment. Segmental recovery was examined after 8 (5-15) months. Two hundred-forty-eight segments were dysfunctional with presence of DE in 193. DOB-MRI showed the best prediction of recovery at 10 microg*kg(-1)*min(-1) of dobutamine with sensitivity of 67%, specificity of 63% and accuracy of 66% using a cut-off value for SWT of 2.0 mm. DE revealed a sensitivity of 68%, specificity of 65% and accuracy of 67% using a cut-off value of 46%. Combined analysis of DOB-MRI and DE did not improve diagnostic performance. Early prediction of segmental myocardial recovery after AMI is possible with DOB-MRI and DE. No improvement is achieved by dobutamine >10 microg*kg(-1)*min(-1) or a combination of DOB-MRI and DE.
authors: Clinic of Cardiology/Angiology, University Heart-Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. barmeyer@uke.uni-hamburg.de
authors: Achim A
authors: AA
authors: Barmeyer
authors: Alexander
authors: A
authors: Stork
authors: Martin
authors: M
authors: Bansmann
authors: Kai
authors: K
authors: Muellerleile
authors: Mirko
authors: M
authors: Heuer
authors: Markus
authors: M
authors: Bavastro
authors: Gerhard
authors: G
authors: Adam
authors: Thomas
authors: T
authors: Meinertz
authors: Gunnar K
authors: GK
authors: Lund
mesh_terms: D002316:Cardiotonic Agents / Q000008:administration & dosage; D003287:Contrast Media; D017023:Coronary Angiography; D004280:Dobutamine / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology*; D015425:Myocardial Reperfusion; D012372:ROC Curve
chemical_list: D002316:Cardiotonic Agents; D003287:Contrast Media; D004280:Dobutamine; D019786:Gadolinium DTPA
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