The combined pharmacological stress echocardiography protocol for predicting improvement of global left ventricular systolic function after revascularisation.
BACKGROUND
We compared the prognostic power of three pharmacological stress echocardiography protocols for predicting improvement of global left ventricular systolic function following revascularisation.


METHODS
We enrolled 100 consecutive patients with significant coronary stenosis/occlusion and regional dys-synergy in the affected artery territory. Patients underwent assessment of regional and global left ventricular systolic function. They underwent then three pharmacological stress echocardiography protocols: low dose dobutamine, infra-low dose dipyridamole, combined protocol. All patients underwent coronary revascularisation. Echocardiography was repeated 8 weeks later. Predicted function improvement by the three protocols was compared with actual improvement.


RESULTS
The combined protocol was more sensitive to predict systolic function improvement after revascularisation, but less specific, the diagnostic accuracy was similar among the three protocols. A cutoff value of 6 viable segments best predicted global function improvement with the combined protocol.


CONCLUSIONS
The combined protocol has a higher sensitivity but lower specificity to predict global left ventricular systolic function improvement after revascularisation, as compared to the other two protocols.
Abdel-Salam
Zainab
Z
Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Nammas
Wail
W
D015906:Angioplasty, Balloon, Coronary; D002316:Cardiotonic Agents; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D004176:Dipyridamole; D004280:Dobutamine; D025401:Echocardiography, Stress / Q000379:methods; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013599:Systole; D013997:Time Factors; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D016277:Ventricular Function, Left
D002316:Cardiotonic Agents; D014665:Vasodilator Agents; D004280:Dobutamine; D004176:Dipyridamole