Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
An assessment of dobutamine echocardiography and end-diastolic wall thickness for predicting post-revascularization functional recovery in patients with chronic coronary artery disease
The First Department of Internal Medicine, Shiga University of Medical Science Seta, Tsukinowa-cho, Otsu, Shiga, Japan 520–21
revised 17 October 1996; accepted 23 October 1996.
Correspondence: Takami Furukawa, MD. The First Department of Internal Medicine, Shiga University of Medical Science, Seta, Tsukinowa-cho. Otsu. Shiga. Japan. 520-21
Abstract
AIMS: This study investigated the functional outcome of wall-thinned, akinetic myocardium after revascularization and evaluated the accuracy of dobutamine echocardiography in predicting post-revascularization functional recovery with the assessment of end-diastolic wall thickness in chronic ischaemic patients.
METHODS AND RESULTS: Fifty-three patients underwent dobutamine echocardiography before coronary revascularization. End-diastolic wall thickness was also evaluated before and after revascularization. The sensitivity and specificity of dobutamine echocardiography to predict post-revascularization functional recovery were 69% and 100% in 58 akinetic/dyskinetic segments, and 86% and 57% in 96 hypokinetic segments. Of 19 akinetic/dyskinetic segments with a preserved end-diastolic wall thickness, 17 (89%) showed functional recovery after revascularization, and dobutamine detected 14 (83%) of these 17 segments. Of 39 akinetic/dyskinetic segments with a thinned end-diastolic wall thickness, 15 (38%) achieved functional recovery, whereas dobutamine echocardiography detected recovery in only eight (53%). Further, of these 15 viable, wall-thinned segments, 12 (80%) showed an increased end-diastolic wall thickness after revascularization (mean±SD were from 5·6±0·7 mm at baseline to 7·4±1·3 mm and 9·7±1 mm after 1 week and after 3 months, respectively), and only 5 (42%) of these responded to dobutamine.
CONCLUSION: Dobutamine echocardiography showed a lessened sensitivity to predict post-revascularization functional recovery in akinetic/dyskinetic segments with a thinned end-diastolic wall thickness that subsequently increased in size.
Key Words: Dobutamine echocardiography • end-diastolic wall thickness • revascularization • chronic coronary artery disease • reversibility
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