Does myocardial viability detected by low-dose dobutamine stress echocardiography identify patients following acute myocardial infarction who's left ventricular regional function recovers after revascularization?

1995 ◽  
Vol 8 (3) ◽  
pp. 408
Author(s):  
Klaus Schröder ◽  
Bettina Kürsten ◽  
Heinz Völler ◽  
Hanso Dingerkus ◽  
Heinz-Peter Schultheiss
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Myocardial Viability ◽  
Stress Echocardiography ◽  
Low Dose ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Regional Function

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.

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