title: Evaluation of myocardial viability in old myocardial infarcted patients with CHF: delayed enhancement MRI vs. low-dose dobutamine stress speckle tracking echocardiography.
abstract: The aim of this study was to explore the significance of delayed enhancement magnetic resonance imaging (DE-MRI) combined with two-dimensional speckle tracking echocardiography (STE) and low dose dobutamine stress echocardiography (LDDSE) to assess viable myocardium (VM) in the patients with old myocardial infarction (OMI) associated with congestive heart failure (CHF). Thirty five hospitalized OMI patients with regional wall motion abnormalities and left ventricular ejection fraction (LVEF) < 50% were recruited based on routine echocardiography. The results showed that DE-MRI facilitated the detection of VM, with a sensitivity, specificity and accuracy of 92.41%, 89.19% and 91.32%, respectively. In a parallel test of the two main parameters in STE, the sensitivity, specificity, and accuracy were improved from baseline to LDDSE (71.72% vs. 91.72%, 70.27% vs. 85.14%, and 71.23% vs. 89.50%, P < 0.05). A parallel test involving STE with LDDSE showed high sensitivity for VM. However its specificity and accuracy were lower than DE-MRI, even when combined with LDDSE. Therefore, combining these two methods, improves the sensitivity, specificity and accuracy for assessment of VM. The combination approach is the best option for the evaluation of VM using serial test. It provides further treatment options and prognosis of patients with OMI. LVEF is improved significantly after PCI in OMI patients with VM and CHF.
authors.affiliation: Institute of Cardiovascular Disease Research, Xuzhou Medical University Jiangsu Province, P. R. China.
authors.forename: Chaofan
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Radiology of Affiliated Hospital of Xuzhou Medical University Jiangsu Province, P. R. China.
authors.forename: Shuguang
authors.initials: S
authors.lastname: Han
authors.affiliation: Department of Cardiology of Affiliated Hospital of Xuzhou Medical University Jiangsu Province, P. R. China.
authors.forename: Tongda
authors.initials: T
authors.lastname: Xu
authors.affiliation: Institute of Cardiovascular Disease Research, Xuzhou Medical University Jiangsu Province, P. R. China.
authors.forename: Fengli
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Cardiology of Affiliated Hospital of Xuzhou Medical University Jiangsu Province, P. R. China.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Cardiology of Affiliated Hospital of Xuzhou Medical University Jiangsu Province, P. R. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Radiology of Affiliated Hospital of Xuzhou Medical University Jiangsu Province, P. R. China.
authors.forename: Chunfeng
authors.initials: C
authors.lastname: Hu
authors.affiliation: Institute of Cardiovascular Disease Research, Xuzhou Medical University Jiangsu Province, P. R. China.
authors.forename: Dongye
authors.initials: D
authors.lastname: Li
keywords: Delayed enhancement magnetic resonance imaging; congestive heart failure; low dose dobutamine stress echocardiography; old myocardial infarction; speckle tracking echocardiography; viable myocardium