3 research outputs found
Assessment of patients after coronary artery bypass grafting by dobutamine stress echocardiography
Dobutamine stress echocardiography is an accurate method for the diagnosis and localization of vascular compromise in patients evaluated after coronary artery bypass graft surgery. The test provides useful data for selection of patients for whom coronary angiography may be indicated
Relation between ST segment elevation during dobutamine stress test and myocardial viability after a recent m
OBJECTIVE: To assess the relation between ST segment elevation during the
dobutamine stress test and late improvement of function after acute Q wave
myocardial infarction. PATIENTS AND DESIGN: 70 patients were studied a
mean (SD) 8 (3) days after acute myocardial infarction with high dose
dobutamine-atropine stress echocardiography and a follow up echocardiogram
at 85 (10) days. A score model based on 16 segments and four grades was
used to assess left ventricular function. Functional improvement was
defined as a reduction of wall motion score > or = 1 in > or = 1 segments
at follow up. INTERVENTION: Myocardial revascularisation was performed in
23 patients (33%) before follow up studies. RESULTS: ST segment elevation
occurred in 40 patients (57%). Late functional improvement occurred in 35
patients (50%). Functional improvement was more common in patients with ST
segment elevation (68% v 30%, P < 0.005) and they had a higher mean (SD)
number of improved segments at follow up (1.9 (2.2) v 0.5 (1.1), P <
0.005). The wall motion score index decreased between baseline and follow
up in patients with ST segment elevation (1.54 (0.50) v 1.48 (0.43), P <
0.05) but not in patients without ST segment elevation (1.39 (0.60) v 1.45
(0.47)). The accuracy of ST segment elevation for the prediction of
functional improvement was similar to that of low dose dobutamine
echocardiography in patients with anterior infarction (80% v 83%) and in
patients who underwent revascularisation (78% v 83% respectively).
CONCLUSION: In patients with a recent Q wave myocardial infarction,
dobutamine-induced ST segment elevation is a valuable marker of myocardial
viability particularly when the test is performed without or with
suboptimal echocardiographic imaging