title: Microvascular damage after coronary artery bypass surgery: assessment using dobutamine stress myocardial contrast echocardiography.
abstract: BACKGROUND
  Although dobutamine stress myocardial contrast echocardiography (DSMCE) has been widely used for the prediction of myocardial functional recovery, dynamic changes that occur at the microcirculatory level during stress have been studied limitedly. The objective of the present study was to use low-dose DSMCE to assess microvascular damage and predict myocardial functional recovery in coronary artery disease (CAD) patients receiving coronary artery bypass grafting.
  
  
  METHODS
  Forty-six CAD patients were subjected to low-dose DSMCE, as well as echocardiography and coronary computed tomography angiography before revascularization, 1 year after coronary artery bypass grafting. Dynamic changes occurring at the microcirculatory level during stress were analyzed for the ability to predict functional recovery. Quantitative assessment of functional recovery was determined using myocardial blood flow (MBF) via receiver operating characteristic curve analyses.
  
  
  RESULTS
  Patients who failed to recover had fewer changes in MBF (ΔMBF) at rest and with stress compared with the segments showing functional recovery. Semiquantitative changes (enhanced or reduced) of the myocardial perfusion score (ΔMPS) and quantitative changes in ΔMBF of stress myocardial contrast echocardiography enhanced the specificity of resting MPS and the sensitivity of wall motion scores (P < 0.05) for the prediction of functional recovery.
  
  
  CONCLUSIONS
  Specific stress ΔMBF more accurately reflected the extent of microvascular damage compared with wall motion scores and resting MPS. ΔMBF and ΔMPS under stress myocardial contrast echocardiography provided higher accuracy than wall motion scores and resting MPS in predicting functional recovery in CAD patients after revascularization.
authors: Departments of Cardiovascular Surgery (CL, LN, ZL, BW, GZ, LX, HL), Cardiology (CX, JS), and Computer Tomography (XX, KZ), The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
authors: Chang
authors: C
authors: Liu
authors: Chunhong
authors: C
authors: Xiu
authors: Xigang
authors: X
authors: Xiao
authors: Lixin
authors: L
authors: Ni
authors: Zonghong
authors: Z
authors: Liu
authors: Baichun
authors: B
authors: Wang
authors: Jingxia
authors: J
authors: Shen
authors: Kai
authors: K
authors: Zhu
authors: Guowei
authors: G
authors: Zhang
authors: Lei
authors: L
authors: Xu
authors: Hongyu
authors: H
authors: Liu
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D003326:Coronary Circulation / Q000502:physiology; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology
chemical_list: D004280:Dobutamine