[Low-dose adenosine echocardiography for detection of myocardial viability in patients with acute myocardial infarction.].
OBJECTIVE
To evaluate the value of low-dose adenosine echocardiography (LDAE) for detection of myocardial viability in patients with acute myocardial infarction (MI).


METHODS
Thirty-six patients underwent LDAE within 3 - 10 days after onset of first acute MI before (n = 4) or after (n = 32) percutaneous coronary intervention. A 17-segment semi-quantitative scoring model was adopted. Wall motion improvement derived from two dimensional images at follow-up (2 - 3 months after acute MI) comparing baseline before adenosine infusion was used as gold criteria for myocardial viability.


RESULTS
Low-dose adenosine slightly increased heart rates [(70.7 +/- 10.8) beats/min vs. (78.1 +/- 10.9) beats /min, P < 0.01] and also significantly reduced left ventricular endsystolic volume [(30.4 +/- 1.9) ml vs. (20.1 +/- 9.3) ml, P < 0.01] and increased ejection fraction (62.6% +/- 10.4% vs. 74.7% +/- 9.8%, P < 0.01). The sensitivity, specificity, diagnostic accuracy, positive and negative prective values of LDAE for identification of viable myocardium were 90.3%, 80.8%, 86.0%, 84.8% and 87.5%, respectively. Incidence of mild adverse reaction during LDAE was 38.9% (14/36). LDAE at dose of 100 microgxkg(-1)xmin(-1) was ideal in terms of balanced sensitivity and specificity for detecting viable myocardium without increasing the adverse effects compared to lower doses.


CONCLUSIONS
LDAE (100 microgxkg(-1)xmin(-1)) has excellent sensitivity and specificity for detecting viable myocardium in acute MI with only minimal adverse effects.
Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. Email: fanglg@yahoo.com.
Li-Gang
LG
Fang
Juan
J
Li
Wei
W
Chen
Wen-Ling
WL
Zhu
Quan
Q
Fang
D000241:Adenosine; D004280:Dobutamine / Q000008:administration & dosage; D004452:Echocardiography; D006801:Humans; D009203:Myocardial Infarction; D009206:Myocardium
D004280:Dobutamine; D000241:Adenosine