451. Prediction of long-term effects of revascularization on regional and global left ventricular function by dobutamine echocardiography and rest Tl-201 imaging alone and in combination in patients with chronic coronary artery disease.
- Author
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Dellegrottaglie S, Perrone-Filardi P, Pace L, Prastaro M, Della Morte AM, Ponticelli MP, Piscione F, Storto G, De Luca G, Salvatore M, and Chiariello M
- Subjects
- Adult, Aged, Chronic Disease, Coronary Disease physiopathology, Dobutamine, Female, Humans, Male, Middle Aged, Myocardial Contraction physiology, Observer Variation, Recovery of Function, Sensitivity and Specificity, Stroke Volume physiology, Ventricular Dysfunction, Left physiopathology, Coronary Disease diagnostic imaging, Echocardiography, Stress, Myocardial Revascularization, Thallium Radioisotopes, Tomography, Emission-Computed, Single-Photon, Ventricular Dysfunction, Left diagnostic imaging
- Abstract
Background: The aim of this study was to evaluate the accuracy of low-dose dobutamine echocardiography (DE) and resting thallium 201 single photon emission computed tomography (SPECT) alone and in combination for prediction of functional recovery at late follow-up (1 year) after revascularization., Methods and Results: Twenty-six patients with coronary artery disease and ventricular dysfunction (ejection fraction, 42% +/- 9%) underwent DE and Tl-201 SPECT 14 +/- 9 (mean +/- SD) days before revascularization and repeated echocardiography 12 +/- 5 months thereafter. Discriminant analysis was applied to combine Tl-201 SPECT and DE data to classify dysfunctional segments as viable or nonviable. In 78 akinetic/dyskinetic revascularized segments, Tl-201 SPECT provided a sensitivity of 83% and a specificity of 55%, whereas DE showed a sensitivity of 60% and a specificity of 91%, for prediction of improvement in regional function at follow-up. The combination of data through use of discriminant analysis provided a sensitivity of 80% and a specificity of 86%, with an overall accuracy of 82%, significantly higher than DE (71%; P <.05) and Tl-201 SPECT (73%; P <.05) alone. Moreover, discriminant analysis identified 12 (75%) of 16 patients with and 8 (80%) of 10 patients without significant improvement in ejection fraction at follow-up, with an accuracy of 77%., Conclusions: The combination of Tl-201 SPECT and DE data provides higher accuracy than either technique alone for prediction of recovery of regional and global function after revascularization.
- Published
- 2002
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