Comparison of simultaneous dobutamine echocardiography and thallium-201 stress-reinjection single-photon emission computed tomography in predicting improvement of chronic myocardial dysfunction after revascularization
Journal
American Journal of Cardiology
Journal Volume
86
Journal Issue
3
Pages
293-298
Date Issued
2000
Author(s)
Abstract
Previous studies have shown that ultrasonic integrated backscatter is valuable in characterizing stunned myocardium. Recent investigations have demonstrated that resting cardiac cycle-dependent variation of integrated backscatter closely paralleled the contractile reserve in patients with chronic left ventricular ischemic dysfunction. The purpose of this study was to validate whether ultrasonic tissue characterization (UTC) compared with dobutamine stress echocardiography (DSE) and thallium-201 stress-reinjection single-photon emission computed tomography (Tl-SPECT) could predict reversible myocardial dyssynergy in patients with chronic coronary artery disease. Forty-eight patients with stable coronary artery disease underwent UTC, DSE, and Tl-SPECT simultaneously before successful coronary revascularization and were followed up with echocardiograms at rest >3 months later. Among the 58 investigated segments, the weighted amplitude, a composite parameter derived from the integrated backscatter power curve, was larger for those groups with greater functional recovery (p <0.001). For the persistent akinetic segments, the weighted amplitudes were small with large deviations of the nadir ratios that represented the asynchrony between the intramural contractile events and the global systole. Using the cut-off value 2.0 of the weighted amplitude, the sensitivity and specificity for predicting functional improvement after revascularization were both 82.8% (κ = 0.66) and comparable to the sensitivity and specificity of DSE and Tl-SPECT. UTC, delineating the myocardial physical state and intramural contraction, can be a novel approach in predicting functional improvement of chronic dyssynergy after revascularization. Copyright (C) 2000 Excerpta Medica Inc.
SDGs
Other Subjects
dobutamine; thallium 201; adult; aged; article; clinical article; clinical trial; diagnostic accuracy; echocardiography; female; human; intermethod comparison; male; myocardial disease; priority journal; revascularization; single photon emission computer tomography; ultrasound; Adult; Aged; Cardiotonic Agents; Coronary Disease; Dobutamine; Echocardiography; Female; Follow-Up Studies; Humans; Male; Middle Aged; Myocardial Contraction; Myocardial Revascularization; Predictive Value of Tests; Tomography, Emission-Computed, Single-Photon; Treatment Outcome; Ventricular Dysfunction, Left
Type
journal article