title: Predictors of viability in patients with negative low-dose dobutamine stress echocardiograph.
abstract: BACKGROUND
  Low-dose dobutamine stress echocardiography is specific for predicting reversible contractility dysfunction, but its sensitivity is lower than ideal.
  
  
  OBJECTIVE
  We sought to explore the predictors of myocardial contractile recovery following revascularization, in patients with no viability by low-dose dobutamine stress echocardiography.
  
  
  METHODS
  We prospectively enrolled 30 consecutive patients with significant coronary stenosis/occlusion amenable for revascularization, regional wall motion abnormality in the distribution of the affected artery and absence of viability by low-dose dobutamine stress echocardiography. They underwent resting 99mTc-sestamibi imaging study, and then underwent successful coronary revascularization. Follow-up echocardiography was performed 3 months later. Patients were classified into 2 groups: group 1: with evidence of myocardial contractile recovery after revascularization at follow-up echocardiography and group 2: with no such evidence of recovery. The two groups were compared with respect to patients' clinical, echocardiographic and scintigraphic data.
  
  
  RESULTS
  The mean age was 52.3 ± 5.9 years, with 97% being males. The percentage of total 99mTc-sestamibi uptake was significantly higher in group 1 as compared to group 2 (p < 0.01), and it was the strongest independent predictor of myocardial contractile recovery at 3-month follow-up by multivariate regression analysis. Receiver operating characteristics curve revealed that a cutoff value of the percentage of total 99mTc-sestamibi uptake of 72% best predicted myocardial contractile recovery, with a sensitivity of 100% and specificity of 95.7%.
  
  
  CONCLUSIONS
  In patients with no viability by low-dose dobutamine stress echocardiography, the percentage of total 99mTc-sestamibi uptake independently predicted myocardial contractile recovery following coronary revascularization.
authors.affiliation: Cardiology Department, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt.
authors.forename: Zainab
authors.initials: Z
authors.lastname: Abdel-Salam
authors.forename: Wail
authors.initials: W
authors.lastname: Nammas
mesh_terms: D004305:Dose-Response Relationship, Drug; D025401:Echocardiography, Stress / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009200:Myocardial Contraction / Q000502:physiology*; D009204:Myocardial Revascularization / Q000534:rehabilitation*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D019275:Radiopharmaceuticals; D020127:Recovery of Function; D012307:Risk Factors; D017256:Technetium Tc 99m Sestamibi
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi