Perfusion-contraction mismatch during inotropic stimulation in hibernating myocardium

Gianmario Sambuceti, Assuero Giorgetti, Luca Corsiglia, Cecilia Marini, Jan Schneider-Eicke, Claudio Brunelli, Paolo Marzullo, Antonio L'Abbate, Salvatore Capponnetto, Oberdan Parodi

Research output: Contribution to journalArticlepeer-review

Abstract

The aims of this study were to assess the value of dobutamine echocardiography in identifying myocardial hibernation versus stunning and to elucidate the underlying pathophysiological mechanism of the contractile impairment. Methods: Twenty-one patients with isolated stenosis of the left anterior descending artery were evaluated 1 mo after thrombolysed acute anterior infarction. Regional function and blood flow were measured using echocardiography and PEt at rest and during dobutamine administration (10 μg/kg/min). Results: Defined by [18F]fluorodeoxyglucose uptake, 36 of 102 dyssynergic segments were necrotic, and 66 were viable. The latter segments were subdivided according to their [13N]ammonia flow distribution: 30 hibernating regions with perfusion defects (flow of -1 · g-1; not significant), and both resting values were lower than those seen in stunning (0.79 ± 0.24; p <0.05). Flow response to dobutamine was markedly reduced in necrosis (dobutamine/resting flow = 1.16 ± 0.27), whereas it was maintained in hibernation (1.65 ± 0.54) and stunning (1.42 ± 0.57). Dobutamine improved function in a higher number of stunned (55%) than hibernating (16%) or necrotic (11%) segments. Conclusion: Dobutamine improves function mainly in stunned myocardium and does not reliably identify hibernation. The lack of functional response in hibernation is not related to an exhausted vasodilating capacity.

Original languageEnglish
Pages (from-to)396-402
Number of pages7
JournalJournal of Nuclear Medicine
Volume39
Issue number3
Publication statusPublished - Mar 1998

Keywords

  • Echocardiography
  • Myocardial blood flow
  • Myocardial infarction
  • PET

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

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