Knowledge of perfusion and contractile reserve improves the predictive value of recovery of regional myocardial function postrevascularization: A study using the combination of myocardial contrast echocardiography and dobutamine echocardiography

Mario F. Meza, Stephen Ramee, Tyrone Collins, Dwight Stapleton, Richard V. Milani, Joseph P Murgo, Jorge Cheirif

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Background: This study was designed to determine the value of myocardial contrast echocardiography (MCE) and dobutamine echocardiography (DE), alone or in combination, in predicting functional recovery in patients with resisting wall motion abnormalities due to CAD, MCE and DE have been independently shown to be useful in detecting myocardial viability in the post-myocardial infarction setting. Methods and Results: Thirty-nine patients with significant coronary artery disease and resting wall motion abnormalities underwent DE (2.5 to 20 μg · kg-1 · min-1) and wall motion analysis (16-segment model). MCE was performed with selective intracoronary injections of sonicated meglumine (2 cm3). Myocardial viability was defined as presence of contrast effect by MCE and contractile reserve or an ischemic response by DE. Functional recovery (improvement in wall motion) was assessed after revascularization (percutaneous trasluminal coronary angioplasty, n = 20; coronary artery bypass surgery, n = 19). When the two groups of patients were analyzed, MCE was associated with excellent sensitivities (84%) yet poor specificities (19% to 26%); DE had lower sensitivities (79% to 80%) but also poor specificities (30% to 36%). The combination of both was associated with excellent sensitivities (90% to 93%) and modest specificities (48% to 50%) for predicting functional recovery. A biphasic response with DE was infrequent (14% to 42%) but highly specific to functional recovery for functional recovery (83%). Conclusions: The prediction of functional recovery post-revascularization can be enhanced by combining MCE and DE.

Original languageEnglish (US)
Pages (from-to)3459-3465
Number of pages7
JournalCirculation
Volume96
Issue number10
StatePublished - Nov 18 1997
Externally publishedYes

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Dobutamine
Echocardiography
Perfusion
Meglumine
Percutaneous Coronary Intervention
Angioplasty
Coronary Artery Bypass
Coronary Artery Disease

Keywords

  • Contractility
  • Myocardium
  • Perfusion
  • Revascularization

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Knowledge of perfusion and contractile reserve improves the predictive value of recovery of regional myocardial function postrevascularization : A study using the combination of myocardial contrast echocardiography and dobutamine echocardiography. / Meza, Mario F.; Ramee, Stephen; Collins, Tyrone; Stapleton, Dwight; Milani, Richard V.; Murgo, Joseph P; Cheirif, Jorge.

In: Circulation, Vol. 96, No. 10, 18.11.1997, p. 3459-3465.

Research output: Contribution to journalArticle

Meza, Mario F. ; Ramee, Stephen ; Collins, Tyrone ; Stapleton, Dwight ; Milani, Richard V. ; Murgo, Joseph P ; Cheirif, Jorge. / Knowledge of perfusion and contractile reserve improves the predictive value of recovery of regional myocardial function postrevascularization : A study using the combination of myocardial contrast echocardiography and dobutamine echocardiography. In: Circulation. 1997 ; Vol. 96, No. 10. pp. 3459-3465.
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abstract = "Background: This study was designed to determine the value of myocardial contrast echocardiography (MCE) and dobutamine echocardiography (DE), alone or in combination, in predicting functional recovery in patients with resisting wall motion abnormalities due to CAD, MCE and DE have been independently shown to be useful in detecting myocardial viability in the post-myocardial infarction setting. Methods and Results: Thirty-nine patients with significant coronary artery disease and resting wall motion abnormalities underwent DE (2.5 to 20 μg · kg-1 · min-1) and wall motion analysis (16-segment model). MCE was performed with selective intracoronary injections of sonicated meglumine (2 cm3). Myocardial viability was defined as presence of contrast effect by MCE and contractile reserve or an ischemic response by DE. Functional recovery (improvement in wall motion) was assessed after revascularization (percutaneous trasluminal coronary angioplasty, n = 20; coronary artery bypass surgery, n = 19). When the two groups of patients were analyzed, MCE was associated with excellent sensitivities (84{\%}) yet poor specificities (19{\%} to 26{\%}); DE had lower sensitivities (79{\%} to 80{\%}) but also poor specificities (30{\%} to 36{\%}). The combination of both was associated with excellent sensitivities (90{\%} to 93{\%}) and modest specificities (48{\%} to 50{\%}) for predicting functional recovery. A biphasic response with DE was infrequent (14{\%} to 42{\%}) but highly specific to functional recovery for functional recovery (83{\%}). Conclusions: The prediction of functional recovery post-revascularization can be enhanced by combining MCE and DE.",
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T2 - A study using the combination of myocardial contrast echocardiography and dobutamine echocardiography

AU - Meza, Mario F.

AU - Ramee, Stephen

AU - Collins, Tyrone

AU - Stapleton, Dwight

AU - Milani, Richard V.

AU - Murgo, Joseph P

AU - Cheirif, Jorge

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N2 - Background: This study was designed to determine the value of myocardial contrast echocardiography (MCE) and dobutamine echocardiography (DE), alone or in combination, in predicting functional recovery in patients with resisting wall motion abnormalities due to CAD, MCE and DE have been independently shown to be useful in detecting myocardial viability in the post-myocardial infarction setting. Methods and Results: Thirty-nine patients with significant coronary artery disease and resting wall motion abnormalities underwent DE (2.5 to 20 μg · kg-1 · min-1) and wall motion analysis (16-segment model). MCE was performed with selective intracoronary injections of sonicated meglumine (2 cm3). Myocardial viability was defined as presence of contrast effect by MCE and contractile reserve or an ischemic response by DE. Functional recovery (improvement in wall motion) was assessed after revascularization (percutaneous trasluminal coronary angioplasty, n = 20; coronary artery bypass surgery, n = 19). When the two groups of patients were analyzed, MCE was associated with excellent sensitivities (84%) yet poor specificities (19% to 26%); DE had lower sensitivities (79% to 80%) but also poor specificities (30% to 36%). The combination of both was associated with excellent sensitivities (90% to 93%) and modest specificities (48% to 50%) for predicting functional recovery. A biphasic response with DE was infrequent (14% to 42%) but highly specific to functional recovery for functional recovery (83%). Conclusions: The prediction of functional recovery post-revascularization can be enhanced by combining MCE and DE.

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