Sensitivity, specificity, and predictive accuracies of non-invasive tests, singly and in combination, for diagnosis of hibernating myocardium

• Published in: European heart journal 2000-08, Vol.21 (16), p.1358-1367
• Main Authors: LaCanna, G, Rahimtoola, S.H, Visioli, O, Giubbini, R, Alfieri, O, Zognio, M, Milan, E, Ceconi, C, Gargano, M, LoRusso, R, Ferrari, R
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Cardiology. Vascular system; Cardiotonic Agents - administration & dosage; Coronary heart disease; Diastole; Dobutamine - administration & dosage; Echocardiography; Exercise Test; Heart; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Infusions, Intravenous; Medical sciences; Middle Aged; Myocardial Contraction - physiology; Myocardial Revascularization; Myocardial Stunning - diagnosis; Myocardial Stunning - physiopathology; Myocardial Stunning - surgery; Prognosis; Prospective Studies; Radionuclide Ventriculography; Recovery of Function - physiology; Reproducibility of Results; Sensitivity and Specificity; Thallium Radioisotopes; Ventricular Function, Left - physiology
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1053/euhj.1999.2038

Objective To determine the best test(s) for predicting functional recovery of hibernating myocardium after reperfusion. Methods A prospective study to compare echocardiographic left ventricular diastolic wall thickness (≥5mm), low-dose dobutamine echocardiography and rest-redistribution thallium-201 scintigraphy, alone and in combination, for predicting recovery of left ventricular akinesis after surgical revascularization. Results Twenty-eight consecutive patients aged 58±9 years were studied. Of the 448 left ventricular segments, 263 were akinetic at rest; 230/263 (87%) had wall thickness ≥5mm, 135 (51%) had a positive response and 175 (66·5%) were graded viable on thallium. Of akinetic segments 61% improved after surgery. Left ventricular score decreased from 2·3±0·4 to 1·8±0·4 (P