Left ventricular remodeling can be predicted with left ventricular volume response during dobutamine echocardiography after acute myocardial infarction.
OBJECTIVE
This study was performed to evaluate the significance of left ventricular (LV) volume response during dobutamine stress echocardiography (DSE) in the prediction of LV volume change during follow-up (F/U) in patients with acute myocardial infarction (AMI).


METHODS
Forty-five patients with AMI (male 39, age 57+/-10 y, anterior myocardial infarction [MI] 29) underwent DSE 6+/-4 d after AMI. Revascularization of the infarct-related artery was performed if severe stenosis was present. A F/U echocardiography was performed 7.5+/-3.4 mo after DSE. The LV end-diastolic volume (EDV) and end-systolic volume (ESV) using the modified Simpson's method were measured at baseline echocardiography, low-dose (10 microg x kg(-1) x min(-1)) DSE, and F/U echocardiography.


RESULTS
Patients were divided into 2 groups; Group I (n = 21) with an abnormal response (<10% decrease) in LVEDV during low-dose DSE; Group II (n = 24) with a normal response (> or =10% decrease) in LVEDV during low-dose DSE. At F/U echocardiography, the (%) change of LVEDV was significantly different between the 2 groups (-2.0+/-16.7 versus - 22.6+/-24.7%, p<0.01). Using multivariate analysis, the response of LVEDV (%) at low-dose DSE was the only significant independent predictor of the change of LVEDV (%) during F/U (y = 0.85 x - 0.03, r = 0.63, p<0.001).


CONCLUSIONS
The response of LVEDV during DSE can be used as a predictor for the LV volume change after AMI.
Cardiology Division, Yonsei University College of Medicine, Seoul, Korea. sejoong@yumc.yonsei.ac.kr
Se-Joong
SJ
Rim
Jong-Won
JW
Ha
Moon-Hyoung
MH
Lee
Yangsoo
Y
Jang
Namsik
N
Chung
D002306:Cardiac Volume / Q000502:physiology*; D002316:Cardiotonic Agents; D004280:Dobutamine; D025401:Echocardiography, Stress / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D020257:Ventricular Remodeling / Q000502:physiology*
D002316:Cardiotonic Agents; D004280:Dobutamine