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Eur J Heart Fail. 2007 Apr;9(4):403-8. Epub 2006 Dec 12.

Myocardial viability estimation during the recovery phase of stress echocardiography after acute beta-blocker administration.

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1
Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.

Abstract

BACKGROUND:

Myocardial viability assessment in severely dysfunctional segments by dobutamine stress echocardiography (DSE) is less sensitive than nuclear scanning.

AIM:

To assess the additional value of using the recovery phase of DSE after acute beta-blocker administration for identifying viable myocardium.

METHODS:

The study included 49 consecutive patients with ejection fraction (LVEF)<or=35%. All patients underwent DSE evaluation at low-high dose and during recovery phase, and dual-isotope single photon emission tomography (DISA-SPECT) evaluation for viability of severely dysfunctional segments. Patients with >or=4 viable segments were considered viable. Coronary revascularization followed within 3 months in all patients. Radionuclide evaluation of LVEF was performed before and 12 months after revascularization.

RESULTS:

Viability with DISA-SPECT was detected in 463 (59%) segments, while 154 (19.7%) segments presented as scar. The number of viable segments increased from 415 (53%) at DSE to 463 (59%) at DSE and recovery, and the number of viable patients increased from 43 to 49 respectively. LVEF improved by >or=5% in 27 patients. Multivariate regression analysis showed that, DSE with recovery phase was the only independent predictor of >or=5% LVEF improvement after revascularization (OR 14.6, CI 1.4-133.7).

CONCLUSION:

In this study, we demonstrate that the recovery phase of DSE has an increased sensitivity for viability estimation compared to low-high dose DSE.

PMID:
17166767
DOI:
10.1016/j.ejheart.2006.10.018
[Indexed for MEDLINE]
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