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6. Low dose dobutamine echocardiography for predicting functional recovery after coronary revascularisation

Author

M. Prastaro, G. De Luca, Santo Dellegrottaglie, Pasquale Perrone-Filardi, Massimo Chiariello, Ciro Indolfi, Federico Piscione, Paolo Golino, Piscione, F, Perrone Filardi, P, De Luca, G, Prastaro, M, Indolfi, C, Golino, Paolo, Dellegrottaglie, S, Chiariello, M., Piscione, Federico, PERRONE FILARDI, Pasquale, DE LUCA, G, Golino, P, and Chiariello, Massimo

Subjects
Male, medicine.medical_specialty, Cardiotonic Agents, Cardiovascular Medicine, Anterior Descending Coronary Artery, Coronary Angiography, Sensitivity and Specificity, Ventricular Function, Left, Dobutamine, Internal medicine, Myocardial Revascularization, medicine, Humans, Prospective Studies, Derivation, Angioplasty, Balloon, Coronary, Coronary Artery Bypass, Prospective cohort study, Retrospective Studies, Tomography, Emission-Computed, Single-Photon, Interventional cardiology, business.industry, Coronary Stenosis, Stroke Volume, Stroke volume, Middle Aged, medicine.disease, Thallium Radioisotopes, Stenosis, Coronary occlusion, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Echocardiography, Stress, Follow-Up Studies, medicine.drug
Abstract

OBJECTIVE—To evaluate the effects of chronic coronary occlusion on the accuracy of low dose dobutamine echocardiography in predicting recovery of dysfunctional myocardium after revascularisation. DESIGN—Retrospective study. SETTING—Tertiary referral centre. PATIENTS—53 consecutive patients with ⩾ 70% stenosis of the left anterior descending coronary artery (LAD) and regional ventricular dysfunction (group 1, non-occluded LAD; group 2, occluded LAD) who underwent dobutamine echocardiography. INTERVENTIONS—26 patients underwent coronary artery bypass grafting and 27 had percutaneous transluminal coronary angioplasty. MAIN OUTCOME MEASURES—Baseline studies before revascularisation included cross sectional echocardiography at rest and during dobutamine infusion (5-10 µg/kg/min), and coronary angiography. The dobutamine study was performed mean (SD) 35 (28) days before revascularisation. Echocardiography at rest was repeated 90 (48) days after revascularisation. RESULTS—Of 296 dysfunctional segments, 63 in group 1 (43%; 63/146) and 69 in group 2 (46%; 69/150) (NS) improved at follow up. Mean (SD) regional wall motion score index decreased from 1.97 (0.48) (95% confidence interval (CI) 1.01 to 2.93) before revascularisation to 1.74 (0.52) (95% CI 0.70 to 2.78) at follow up in group 1 (p = 0.001), and from 2.12 (0.41) (95% CI 1.30 to 2.98) to 1.88 (0.36) (95% CI 1.16 to 2.60) in group 2 (p = 0.0006). In group 1, sensitivity (87% v 52%; p

Published
2001
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