Enoximone echocardiography for predicting recovery of left ventricular dysfunction after revascularization: A novel test for detecting myocardial viability

Chunzeng Lu, Mauro Carlino, Gabriele Fragasso, Francesco Maisano, Alberto Margonato, Alberto Cappelletti, Sergio L. Chierchia

Research output: Contribution to journalArticle

Abstract

Background - The possibility that enoximone, a nonglycoside, noncatechol, positive inotropic agent, in combination with 2-dimensional echocardiography may predict recovery of myocardial dysfunction after revascularization has not been yet evaluated. Methods and Results - Forty- five patients with chronic coronary artery disease and left ventricular dysfunction underwent dobutamine (DE, 5 to 10 μg · kg-1 · min-1) and enoximone (EE, 1.5 mg/kg, over 10 minutes) echocardiography. Myocardial wall motion was scored from 1 (normal) to 4 (dyskinesia): an asynergic segment was considered to have contractile enhancement when the score decreased by ≥1 grade. Of 478 asynergic segments, 216 (45%) exhibited functional recovery after revascularization. Dobutamine- and enoximone-induced contractile enhancement was observed in 41% and 46% of segments, respectively. Compared with DE, EE had higher sensitivity (88% versus 79%, P <0.01) and negative predictive value (90% versus 84%, P <0.05) in predicting functional recovery. The specificity (89% versus 90%) and positive predictive value (87% for both EE and DE) were similar. Concordant interpretation of EE and DE findings was found in 85% (406 of 478) of affected segments. Prerevascularization coronary angiography showed that stenosis severity of vessels supplying areas which only improved with enoximone was significantly greater (89.9%) than that of vessels (77.7%) supplying areas that responded to both agents (P <0.02). Both dobutamine and enoximone increased heart rate (16% and 10%, respectively), whereas enoximone did not cause changes in systolic blood pressure that increased by 14% with dobutamine. Conclusions - Enoximone echocardiography provides a novel and reliable approach for the prediction of functional recovery after revascularization. Compared with dobutamine echocardiography, the test yields higher sensitivity and induces lesser hemodynamic alterations.

Original languageEnglish
Pages (from-to)1255-1260
Number of pages6
JournalCirculation
Volume101
Issue number11
Publication statusPublished - Mar 21 2000

Keywords

  • Dobutamine
  • Echocardiography
  • Enoximone
  • Myocardial viability

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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