scholarly journals Presence of left ventricular apical thrombus predicts lack of myocardial viability: A dobutamine stress echocardiography study

1996 ◽  
Vol 27 (2) ◽  
pp. 369 ◽  
Author(s):  
David A. Cusick ◽  
Gorav Ailawadi ◽  
Jason T. Tauke ◽  
Michele A. Parker ◽  
Robert O. Bonow ◽  
...  
Keyword(s):  
Myocardial Viability ◽  
Stress Echocardiography ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress ◽  
Left Ventricular

scholarly journals Comparison of Contrast Enhanced Low-Dose Dobutamine Stress Echocardiography with 99mTc-Sestamibi Single-Photon Emission Computed Tomography in Assessment of Myocardial Viability

2019 ◽  
Vol 7 (8) ◽  
pp. 1287-1292
Author(s):  
Bhupendra Verma ◽  
Amrita Singh
Keyword(s):  
Myocardial Viability ◽  
Stress Echocardiography ◽  
Low Dose ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Contrast Enhanced ◽  
Myocardial Perfusion Scan ◽  
Perfusion Scan ◽  
99Mtc Sestamibi

INTRODUCTION: Dobutamine stress echocardiography (DSE) and myocardial perfusion scan are the commonly used modalities to detect viable myocardium. DSE is comparatively cheaper and widely available but has a lower sensitivity. AIM: We aimed to compare contrast-enhanced low-dose dobutamine echocardiography (LDDE) and gated 99mTc-sestamibi myocardial perfusion scan (MPS) for the degree of agreement in the detection of myocardial viability. METHODS: We studied 850 left ventricular segments from 50 patients (42 men, mean age 55.5 years), with coronary artery disease and left ventricular systolic dysfunction (ejection fraction < 40%), using contrast-enhanced LDDE and 99mTc-Sestamibi gated SPECT. Segments were assessed for the presence of viability by both techniques and head to head comparisons were made. RESULTS: Adequate visualisation increased from 80% in unenhanced segments to 96% in contrast-enhanced segments. Of the total 850 segments studied, 290 segments (34.1%) had abnormal contraction (dysfunctional). Among these, 138 were hypokinetic (16.2% of total), 144 were severely hypokinetic or akinetic (16.9% of total), and 8 segments were dyskinetic or aneurismal (0.9% of total). Among 151 segments considered viable by technetium, 137 (90.7%) showed contractile improvement with dobutamine; in contrast, only 8 of the 139 segments (5.7%) considered nonviable by technetium had a positive dobutamine response. The per cent of agreement between technetium uptake and a positive response to dobutamine was 78.6% with kappa = 0.63, suggestive of a substantial degree of agreement between the two modalities. CONCLUSION: Use of contrast-enhanced LDDE significantly increased the adequate endocardial border visualisation. Furthermore, this study showed a strong degree of agreement between the modalities in the detection of viable segments. So, contrast-enhanced LDDE appears to be a safe and comparable alternative to MPS in myocardial viability assessment.

scholarly journals Dobutamine Stress Echocardiography with B-Mode Speckle Tracking in Patients after Acute Coronary Syndromes: Diagnostic and Prognostic Value

2020 ◽  
pp. 28-37
Author(s):  
S. V. Potashev ◽  
S. V. Salo ◽  
A. Y. Gavrylyshyn ◽  
S. A. Rudenko ◽  
O. M. Holtvian
Keyword(s):  
Coronary Artery ◽  
Myocardial Viability ◽  
Speckle Tracking ◽  
Stress Echocardiography ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Low Grade ◽  
Coronary Reserve

  Background. Speckle tracking echocardiography (STE) provides valuable data on myocardial function. STE during dobutamine stress echocardiography (DSE) allows reliable myocardial ischemia diagnosis. Aim. To evaluate STE during DSE in patients with coronary artery disease (CAD) after acute coronary syndrome (ACS) and its accuracy in ischemia diagnosis, assessment of myocardial viability and coronary reserve. Methods. We examined 58 patients (55 [94,8 %] men and 3 [5,2 %] women) men) with CAD after ACS admitted to our Institute for defining indications for coronary interventions. All the patients underwent DSE with STE for longitudinal strain quantification. Results. Mean left ventricular ejection fraction (LVEF) was 52.4±5.8%. Significant CAD according to coronary angiography (CAG) prior to DSE was proved in 38 (65.5%) patients. All the patients had a history of ACS up to 12 years before the examination (38 [65.5%] patients after percutaneous coronary intervention (PCI), including 18 [31.0%] primary PCI; 9 [15.5%] patients after coronary artery bypass grafting (CABG); 3 [5.2%] after graft PCI, 1 [1.72%] patient after aortic valve replacement (AVR) with dilated cardiomyopathy (DCM) phenotype). There were no significant complications during DSE: 5 (8.6%) cases of relatively low grade transient arrhythmia with no need for intervention. As per DSE results, we performed 35 (60.3%) revascularization interventions: 31 (58.6%) PCI’s and 4 (6.9%) CABG procedures with good outcomes. It was shown that DSE with STE sensitivity and specificity were 89.7% and 94.7% (AUC 0.92), respectively, with positive and negative predictive values of 97.2% and 81.8%, respectively, with extremely high OR 157.5, p<0.0001. Combined quantification of ΔGLS and ΔWMSI showed insignificantly lower sensitivity (86.3% [p=0.57]) and specificity (87.8% [p=0.19]) vs. integral semiquantitative ischemia markers with significantly lower overall method accuracy (AUC 0.79, p=0.047). Conclusions. DSE with STE as a visualization method is a safe and optimal method for ischemia diagnosis, as well as for myocardial viability and coronary reserve assessment in patients with CAD after ACS with the aim of risk stratification and defining indications for interventions and myocardial revascularization.

scholarly journals Dobutamine Stress Echocardiography for the Bedside Assessment of Viability following a Motor Vehicle Accident and Subsequent Myocardial Infarction: A Case Report

2012 ◽  
Vol 5 ◽  
pp. OJCS.S8319
Author(s):  
Evan L. Brittain ◽  
Waleed N. Irani ◽  
Rashid M. Ahmad ◽  
Ken Monahan
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Viability ◽  
Stress Echocardiography ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Critically Ill Patient ◽  
Anterior Myocardial Infarction

The authors describe a case of a critically ill patient presenting after motor vehicle trauma complicated by anterior myocardial infarction and cardiogenic shock. Assessment of myocardial viability in the territory of a critically stenosed left anterior descending artery (LAD) was necessary to determine the optimal management strategy. Bedside dobutamine stress echocardiography (DSE) demonstrated viability in the LAD territory and the patient underwent uncomplicated single-vessel bypass surgery with subsequent improvement in left-ventricular function. This case illustrates the utility of bedside DSE to assess myocardial viability in patients for whom other non-invasive modalities are not feasible.

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