Time course of myocardial viability after acute myocardial infarction: An echocardiographic study

The recognition of dysfunctional but viable myocardium after acute myocardial infarction (MI) may be of importance for both patient prognostication and the decision for revascularization. Low-dose dobutamine echocardiography (LDDE) has been shown to be a reliable technique in detecting reversibility...

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Bibliographic Details
Published in:The American heart journal 1998, Vol.135 (1), p.51-57
Main Authors: Knudsen, Anne Sejr, Darwish, Ahmed Zaghloul, Nørgaard, Aage, Gøtzsche, Ole, Thygesen, Kristian
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cardiology. Vascular system
Coronary heart disease
Dobutamine
Female
Heart
Humans
Male
Medical sciences
Middle Aged
Myocardial Contraction - drug effects
Myocardial Infarction - diagnostic imaging
Myocardial Infarction - physiopathology
Predictive Value of Tests
Prognosis
Sensitivity and Specificity
Time Factors
Ultrasonography
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Summary:The recognition of dysfunctional but viable myocardium after acute myocardial infarction (MI) may be of importance for both patient prognostication and the decision for revascularization. Low-dose dobutamine echocardiography (LDDE) has been shown to be a reliable technique in detecting reversibility of dysfunctional myocardium. The aim of the present study was to assess by LDDE possible time-dependent changes in myocardial viability and to evaluate the value of LDDE used in the postinfarction period. Twenty-seven patients with acute MI underwent LDDE on day 6, 30, and 90. At LDDE day 6, 41% of the affected segments showed a positive response to LDDE. At later examination on day 30 and 90, only 32% and 18%, respectively, of the dysfunctioning segments responded to dobutamine stimulation, with a significant decline in response ( p < 0.0001), indicating loss of viability. Spontaneous segmental outcome was significantly better for LDDE-responding segments than for nonresponding segments ( p = 0.0001). This study indicated that myocardial viability may be temporary and that a time-dependent loss of viability may take place during the first months after MI. (Am Heart J 1998;135:51-7.)
ISSN:0002-8703
1097-6744
DOI:10.1016/S0002-8703(98)70342-4