Dobutamine stress echocardiography early after myocardial infarction treated with thrombolysis

Mario Previtali, Luca Lanzarini, Arnaldo Poli, Raffaela Fetiveau, Paolo Barberis

Research output: Contribution to journalArticle

Abstract

The aim of the study was to assess the ability of dobutamine stress echocardiography to detect myocardial viability and ischemia in patients with acute myocardial infarction treated with thrombolysis and to correlate the acute response to dobutamine with late spontaneous functional recovery at follow-up. Forty-two consecutive patients with myocardial infarction treated with thrombolysis underwent low- (5 and 10 mcg/kg/min) and high-dose (20 to 40 mcg/kg/min) dobutamine stress echocardiography at a mean of 7 ± 3 days of the acute phase. A follow-up 2D-echocardiogram was performed in all patients to evaluate the spontaneous recovery of function in the infarct area. On the basis of the response to the test, 3 groups of patients were identified: group 1 included 7 patients showing an improvement in left ventricular asynergy score index at low doses (from 1.5 ± 0.3 to 1.3 ± 0.2, p <0.05) with no deterioration at high doses, indicative of myocardial viability without ischemia; group 2 (23 patients) showed a significant improvement in the asynergy index at low doses (from 1.58 ± 0.3 to 1.32 ± 0.32, p <0.05) followed by a deterioration at high doses (1.68 ± 0.4, p <0.05 vs low-dose), suggestive of residual myocardial ischemia in the infarct zone; group 3 included 12 patients who showed no significant changes in the baseline asynergy score index (1.67 ± 0.2) either at low or at high doses. The acute response to dobutamine stress echocardiography accurately predicted the spontaneous recovery of function in the infarct area at follow-up: both group 1 and group 2 patients showed a significant reduction in the asynergy score index (group 1: 1.16 ± 0.3 vs 1.5 ± 0.2, p <0.001; group 2: 1.43 ± 0.3 vs 1.58 ± 0.3, p <0.05), while group 3 had no recovery in the asynergy index (1.67 ± 0.2 vs 1.67 ± 0.2). Thus, in patients with acute myocardial infarction treated with thrombolysis dobutamine stress echocardiography can detect myocardial viability in 71% and ischemia in the infarct zone in 55% of patients; moreover, the response to the test during the acute phase is correlated with the degree of the late spontaneous recovery of function in the infarct area.

Original languageEnglish
Pages (from-to)97-104
Number of pages8
JournalThe International Journal of Cardiac Imaging
Volume12
Issue number2
Publication statusPublished - 1996

Keywords

  • Acute myocardial infarction
  • Dobutamine-stress echocardiography
  • Myocardial ischemia
  • Myocardial viability

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine
  • Radiological and Ultrasound Technology

Fingerprint Dive into the research topics of 'Dobutamine stress echocardiography early after myocardial infarction treated with thrombolysis'. Together they form a unique fingerprint.

  • Cite this