Dobutamine echocardiography in predicting improvement in global left ventricular systolic function after coronary bypass or angioplasty in patients with healed myocardial infarcts

• Published in: The American journal of cardiology 1995-11, Vol.76 (12), p.877-880
• Main Authors: Meluzin, Jaroslav, Cigarroa, Carlos G., Brickner, M.Elizabeth, Cerny, Jan, Spinarova, Lenka, Frelich, Milan, Stetka, Frantisek, Groch, Ladislav, Grayburn, Paul A.
• Format: Article
• Language: English
• Subjects: Angioplasty, Balloon, Coronary; Biological and medical sciences; Cardiotonic Agents; Cardiovascular system; Coronary Artery Bypass; Dobutamine; Echocardiography; Hemodynamics; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - physiopathology; Myocardial Infarction - surgery; Postoperative Period; Predictive Value of Tests; Prognosis; Stroke Volume; Systole; Ultrasonic investigative techniques; Ventricular Function, Left
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(99)80253-7

The aim of this study was to determine whether low-dose dobutamine ecnocardiography (DE) could predict quantitative improvement in global left ventricular (LV) systolic function after coronary revascularization. Low-dose DE was performed in 71 consecutive patients with coronary artery disease and LV dysfunction. Successful coronary bypass surgery or angioplasty was performed in 44 patients, 37 of whom had a resting echocardiogram 1 to 3 months afterward. Group A consisted of 20 patients with contractile reserve during DE, and group B consisted of 17 patients without contractile reserve. As expected, regional wall motion score index (mean ± SD) improved in group A (1.62 ± 0.39 to 1.38 ± 0.31, p < 0.01) but not group B (1.56 ± 0.42 to 1.57 ± 0.41, p = NS). In addition, LV ejection fraction (LVEF) improved after bypass surgery or angio plasty in group A (38 ± 5% to 42 ± 5%, p < 0.01), but not in group B (38 ± 7% to 39 ± 8%, p = NS). In group A, a significant linear correlation was observed between the number of segments with contractile reserve and the improvement in LVEF (r = 0.91, p < 0.0001). A good correlation also existed between the improvement in regional wall motion score index during dobutamine infusion and the improvement in LVEF after bypass surgery or angioplasty (r = 0.90, p < 0.0001). In conclusion, low-dose DE can be used to predict quantitative improvement in global LV systolic function after coronary bypass or angioplasty.