Identification of viable myocardium by echocardiography during dobutamine infusion in patients with myocardial infarction after thrombolytic therapy: comparison with positron emission tomography

Department of Medicine, University of Liege, Belgium.

To assess the presence of viable myocardium salvaged by coronary artery reperfusion, 17 patients with acute anterior myocardial infarction were studied. Each received intravenous thrombolysis within the first 3 h of symptoms and underwent two-dimensional echocardiography before and during dobutamine infusion (10 micrograms/kg per min) 7 +/- 4 days after admission and positron emission tomography 9 +/- 5 days after admission. Echocardiography and positron emission tomography were again performed 9 +/- 7 months later. Six comparable segments specific for the territory of the left anterior descending artery were selected for comparison of the two techniques. Wall thickening was evaluated by using an echocardiographic score index. Segmental perfusion and glucose uptake were measured and normalized to the peak activity. A ratio of glucose uptake to perfusion was calculated for each segment. Concordant interpretation of the two techniques was found in 79% of affected segments for both acute and follow-up studies. Positron emission tomography revealed the presence of viable myocardium in 11 patients (group 1); perfusion was within normal limits in 5 of these (group 1A). Myocardial thickening improved with dobutamine infusion in these five patients, the echocardiographic score index decreasing from 12 +/- 2 at rest to 7.8 +/- 1.3 during dobutamine infusion (p = 0.003). Functional recovery was demonstrated in all five patients (follow-up score index 7.4 +/- 1.7). Six patients exhibited decreased perfusion but an abnormally high glucose to perfusion ratio (group 1B); their score index improved with dobutamine from 14.8 +/- 2.2 to 12 +/- 2.1 (p = 0.05), but late functional recovery was found in only one of the six patients (mean follow-up score index in group 1B 16 +/- 1.7). In the six remaining patients in whom no viable myocardium was detected with positron emission tomography (group 2), the echocardiographic score index did not change with dobutamine (15 +/- 0.9 to 14.7 +/- 0.8, p = NS) and there was no functional recovery (follow-up score index 15.5 +/- 1.0). Echocardiography during dobutamine infusion is a promising method to unmask viable myocardium in acute myocardial infarction. Early recovery of perfusion in the area at risk is associated with a good functional outcome, whereas a high glucose to perfusion ratio indicates jeopardized myocardium that frequently loses viability.

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				A. Manrique, R. Koning, A. Hitzel, A. Cribier, and P. Vera Exercise-induced ST-elevation is related to left ventricular dysfunction but not to myocardial viability in patients with healed myocardial infarction Eur J Heart Fail, December 1, 2001; 3(6): 709 - 716. [Abstract] [Full Text] [PDF]

				F. Jamal, J. Strotmann, F. Weidemann, T. Kukulski, J. D'hooge, B. Bijnens, F. Van de Werf, I. De Scheerder, and G. R. Sutherland Noninvasive Quantification of the Contractile Reserve of Stunned Myocardium by Ultrasonic Strain Rate and Strain Circulation, August 28, 2001; 104(9): 1059 - 1065. [Abstract] [Full Text] [PDF]

				C. Teupe, M. Takeuchi, J. Yao, E. Avelar, and N. Pandian Detection of Viable Myocardium by Transvenous Myocardial Contrast Echocardiography Using Harmonic Power Doppler : Canine Model of Acute Coronary Occlusion and Reperfusion Chest, August 1, 2001; 120(2): 567 - 572. [Abstract] [Full Text] [PDF]

				P Lancellotti, A Albert, C Berthe, and L A Piérard Full recovery of contraction late after acute myocardial infarction: determinants and early predictors Heart, May 1, 2001; 85(5): 521 - 526. [Abstract] [Full Text]

				T Muro, T Ota, H Watanabe, M Teragaki, K Takeuchi, and J Yoshikawa Prediction of contractile reserve by cyclic variation of integrated backscatter of the myocardium in patients with chronic left ventricular dysfunction Heart, February 1, 2001; 85(2): 165 - 170. [Abstract] [Full Text]

				H.-M. J. Siebelink, P. K. Blanksma, H. J. G. M. Crijns, J. J. Bax, A. J. van Boven, T. Kingma, D. A. Piers, J. Pruim, P. L. Jager, W. Vaalburg, et al. No difference in cardiac event-free survival between positron emission tomography-guided and single-photon emission computed tomography-guided patient management: A prospective, randomized comparison of patients with suspicion of jeopardized myocardium J. Am. Coll. Cardiol., January 1, 2001; 37(1): 81 - 88. [Abstract] [Full Text] [PDF]

				J.-P. Bin, R. A. Pelberg, K. Wei, M. Coggins, N. C. Goodman, and S. Kaul Relation between regional function and coronary blood flow reserve in multivessel coronary artery stenosis Am J Physiol Heart Circ Physiol, December 1, 2000; 279(6): H3058 - H3064. [Abstract] [Full Text] [PDF]

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				M Sitges, C Pare, M Azqueta, X Bosch, M VelamazaN, J Magrina, and G Sanz Feasibility and prognostic value of dobutamine-atropine stress echocardiography early in unstable angina Eur. Heart J., July 1, 2000; 21(13): 1063 - 1071. [Abstract] [PDF]

				F.M Baer, P Theissen, J Crnac, M Schmidt, H.J Deutsch, U Sechtem, H Schicha, and E Erdmann Head to head comparison of dobutamine-transoesophageal echocardiography and dobutamine-magnetic resonance imaging for the prediction of left ventricular functional recovery in patients with chronic coronary artery disease Eur. Heart J., June 2, 2000; 21(12): 981 - 991. [Abstract] [PDF]

				K. Takehana, M. Ruiz, F. D. Petruzella, D. D. Watson, G. A. Beller, and D. K. Glover Response to incremental doses of dobutamine early after reperfusion is predictive of the degree of myocardial salvage in dogs with experimental acute myocardial infarction J. Am. Coll. Cardiol., June 1, 2000; 35(7): 1960 - 1968. [Abstract] [Full Text] [PDF]

				C. Lu, M. Carlino, G. Fragasso, F. Maisano, A. Margonato, A. Cappelletti, and S. L. Chierchia Enoximone Echocardiography for Predicting Recovery of Left Ventricular Dysfunction After Revascularization : A Novel Test for Detecting Myocardial Viability Circulation, March 21, 2000; 101(11): 1255 - 1260. [Abstract] [Full Text] [PDF]

				I Ikonomidis, G Athanassopoulos, G Karatasakis, A.S Manolis, M Marinou, A Economou, and D.V Cokkinos Dispersion of ventricular repolarization is determined by the presence of myocardial viability in patients with old myocardial infarction. A dobutamine stress echocardiography study Eur. Heart J., March 2, 2000; 21(6): 446 - 456. [Abstract] [PDF]

				R J Trent, G D Waiter, G S Hillis, F I McKiddie, T W Redpath, and S Walton Dobutamine magnetic resonance imaging as a predictor of myocardial functional recovery after revascularisation Heart, January 1, 2000; 83(1): 40 - 46. [Abstract] [Full Text] [PDF]

				E. P. Hoffer, W. Dewe, C. Celentano, and L. A. Pierard Low-level exercise echocardiography detects contractile reserve and predicts reversible dysfunction after acute myocardial infarction: Comparison with low-dose dobutamine echocardiography J. Am. Coll. Cardiol., October 1, 1999; 34(4): 989 - 997. [Abstract] [Full Text] [PDF]

				J.-L. Monin, J.e. Garot, M. Scherrer-Crosbie, J. Rosso, A.-M. Duval-Moulin, P. Dupouy, E. Teiger, A. Castaigne, J.-C. Cachin, J.-L. Dubois-Rande, et al. Prediction of functional recovery of viable myocardium after delayed revascularization in postinfarction patients: Accuracy of dobutamine stress echocardiography and influence of long-term vessel patency J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1012 - 1019. [Abstract] [Full Text] [PDF]

				F Larrazet, D Pellerin, D Daou, S Witchitz, C Fournier, A Prigent, and C Veyrat Concordance between dobutamine Doppler tissue imaging echocardiography and rest reinjection thallium-201 tomography in dysfunctional hypoperfused myocardium Heart, October 1, 1999; 82(4): 432 - 437. [Abstract] [Full Text] [PDF]

				F. A. Chaudhry, J. T. Tauke, R. S. Alessandrini, G. Vardi, M. A. Parker, and R. O. Bonow Prognostic implications of myocardial contractile reserve in patients with coronary artery disease and left ventricular dysfunction J. Am. Coll. Cardiol., September 1, 1999; 34(3): 730 - 738. [Abstract] [Full Text] [PDF]

				R. Koch, R. M. Lang, M.-J. Garcia, L. Weinert, J. Bednarz, C. Korcarz, B. Coughlan, A. Spiegel, E. Kaji, K. T. Spencer, et al. Objective evaluation of regional left ventricular wall motion during dobutamine stress echocardiographic studies using segmental analysis of color kinesis images J. Am. Coll. Cardiol., August 1, 1999; 34(2): 409 - 419. [Abstract] [Full Text] [PDF]

				R. Senior, S. Kaul, and A. Lahiri Myocardial viability on echocardiography predicts long-term survival after revascularization in patients with ischemic congestive heart failure J. Am. Coll. Cardiol., June 1, 1999; 33(7): 1848 - 1854. [Abstract] [Full Text] [PDF]

				P. Croisille, C. C. Moore, R. M. Judd, J. A. C. Lima, M. Arai, E. R. McVeigh, L. C. Becker, and E. A. Zerhouni Differentiation of Viable and Nonviable Myocardium by the Use of Three-Dimensional Tagged MRI in 2-Day-Old Reperfused Canine Infarcts Circulation, January 19, 1999; 99(2): 284 - 291. [Abstract] [Full Text] [PDF]

				H Yamagishi, K Akioka, M Takagi, A Tanaka, K Takeuchi, J Yoshikawa, and H Ochi Exercise four hour redistribution thallium-201 single photon emission computed tomography and exercise induced ST segment elevation in detecting the viable myocardium in patients with acute myocardial infarction Heart, January 1, 1999; 81(1): 17 - 24. [Abstract] [Full Text]

				E. Picano, R. Sicari, P. Landi, L. Cortigiani, R. Bigi, C. Coletta, A. Galati, J. Heyman, R. Mattioli, M. Previtali, et al. Prognostic Value of Myocardial Viability in Medically Treated Patients With Global Left Ventricular Dysfunction Early After an Acute Uncomplicated Myocardial Infarction : A Dobutamine Stress Echocardiographic Study Circulation, September 15, 1998; 98(11): 1078 - 1084. [Abstract] [Full Text] [PDF]

				M. Previtali, R. Fetiveau, L. Lanzarini, C. Cavalotti, and C. Klersy Prognostic value of myocardial viability and ischemia detected by dobutamine stress echocardiography early after acute myocardial infarction treated with thrombolysis J. Am. Coll. Cardiol., August 1, 1998; 32(2): 380 - 386. [Abstract] [Full Text] [PDF]

				G. Geskin, C. M. Kramer, W. J. Rogers, T. M. Theobald, D. Pakstis, Y.-L. Hu, and N. Reichek Quantitative Assessment of Myocardial Viability After Infarction by Dobutamine Magnetic Resonance Tagging Circulation, July 21, 1998; 98(3): 217 - 223. [Abstract] [Full Text] [PDF]

				G. Mobilia, P. Zanco, A. Desideri, G. Neri, F. Alitto, G. Suzzi, F. Chierichetti, L. Celegon, G. Ferlin, and R. Buchberger T wave normalization in infarct-related electrocardiographic leads during exercise testing for detection of residual viability: comparison with positron emission tomography J. Am. Coll. Cardiol., July 1, 1998; 32(1): 75 - 82. [Abstract] [Full Text] [PDF]

				D. J Duncker, R. Schulz, R. Ferrari, D. Garcia-Dorado, C. Guarnieri, G. Heusch, and P. D Verdouw "Myocardial stunning": remaining questions Cardiovasc Res, June 1, 1998; 38(3): 549 - 558. [Full Text] [PDF]

				R. Belardinelli, D. Georgiou, L. Ginzton, G. Cianci, and A. Purcaro Effects of Moderate Exercise Training on Thallium Uptake and Contractile Response to Low-Dose Dobutamine of Dysfunctional Myocardium in Patients With Ischemic Cardiomyopathy Circulation, February 17, 1998; 97(6): 553 - 561. [Abstract] [Full Text] [PDF]

				M. F. Meza, S. Ramee, T. Collins, D. Stapleton, R. V. Milani, J. P. Murgo, and J. Cheirif Knowledge of Perfusion and Contractile Reserve Improves the Predictive Value of Recovery of Regional Myocardial Function Postrevascularization : A Study Using the Combination of Myocardial Contrast Echocardiography and Dobutamine Echocardiography Circulation, November 18, 1997; 96(10): 3459 - 3465. [Abstract] [Full Text]

				Z.-X. He, R. Medrano, J. T. Hays, J. J. Mahmarian, and M. S. Verani Nitroglycerin-Augmented 201Tl Reinjection Enhances Detection of Reversible Myocardial Hypoperfusion : A Randomized, Double-Blind, Parallel, Placebo-Controlled Trial Circulation, April 1, 1997; 95(7): 1799 - 1805. [Abstract] [Full Text]

				J.-L. J. Vanoverschelde, W. Wijns, M. Borgers, G. Heyndrickx, C. Depre, W. Flameng, and J. A. Melin Chronic Myocardial Hibernation in Humans: From Bedside to Bench Circulation, April 1, 1997; 95(7): 1961 - 1971. [Full Text]

				M. A. Quinones Risk Stratification After Myocardial Infarction: Clinical Science Versus Practice Behavior Circulation, March 18, 1997; 95(6): 1352 - 1354. [Full Text]

				S. C. Smart, T. Knickelbine, T. R. Stoiber, M. Carlos, J. C. Wynsen, and K. B. Sagar Safety and Accuracy of Dobutamine-Atropine Stress Echocardiography for the Detection of Residual Stenosis of the Infarct-Related Artery and Multivessel Disease During the First Week After Acute Myocardial Infarction Circulation, March 18, 1997; 95(6): 1394 - 1401. [Abstract] [Full Text]

				M. E. Carlos, S. C. Smart, J. C. Wynsen, and K. B. Sagar Dobutamine Stress Echocardiography for Risk Stratification After Myocardial Infarction Circulation, March 18, 1997; 95(6): 1402 - 1410. [Abstract] [Full Text]

				M. D. Cheitlin, J. S. Alpert, W. F. Armstrong, G. P. Aurigemma, G. A. Beller, F. Z. Bierman, T. W. Davidson, J. L. Davis, P. S. Douglas, L. D. Gillam, et al. ACC/AHA Guidelines for the Clinical Application of Echocardiography : A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography) Developed in Collaboration With the American Society of Echocardiography Circulation, March 18, 1997; 95(6): 1686 - 1744. [Full Text]

				A. Kranidis, T. Bouki, K. Kostopoulos, P. Anthopoulos, K. Kappos, J. Antonellis, M. Bonou, A. Sideris, D. Ralli, A. Tavernarakis, et al. Stress Echocardiography Using Adenosine Combined with Nitroglycerin- Dobutamine in the Detection of Viable Myocardium in Patients with Previous Myocardial Infarction Angiology, February 1, 1997; 48(2): 127 - 133. [Abstract] [PDF]

				S. H. Rahimtoola Hibernating Myocardium Has Reduced Blood Flow at Rest That Increases With Low-Dose Dobutamine Circulation, December 15, 1996; 94(12): 3055 - 3061. [Full Text]

				K. T. Sun, J. Czernin, J. Krivokapich, Y.-K. Lau, M. Bottcher, G. Maurer, M. E. Phelps, and H. R. Schelbert Effects of Dobutamine Stimulation on Myocardial Blood Flow, Glucose Metabolism, and Wall Motion in Normal and Dysfunctional Myocardium Circulation, December 15, 1996; 94(12): 3146 - 3154. [Abstract] [Full Text]

				J. Sklenar, G. Camarano, N. C. Goodman, S. Ismail, A. R. Jayaweera, and S. Kaul Contractile Versus Microvascular Reserve for the Determination of the Extent of Myocardial Salvage After Reperfusion: The Effect of Residual Coronary Stenosis Circulation, September 15, 1996; 94(6): 1430 - 1440. [Abstract] [Full Text]

				D. Pontillo, G. P. Carboni, A. Capezzuto, C. Alessi, A. Achilli, F. Piccini, and R. Guerra Identification of Viable Myocardium by Nitrate Echocardiography After Myocardial Infarction: Comparison with Planar Thallium Reinjection Scintigraphy Angiology, May 1, 1996; 47(5): 437 - 446. [Abstract] [PDF]

				J.-L. J. Vanoverschelde, B. L. Gerber, A.-M. D'Hondt, M. De Kock, R. Dion, W. Wijns, and J. A. Melin Preoperative Selection of Patients With Severely Impaired Left Ventricular Function for Coronary Revascularization : Role of Low-Dose Dobutamine Echocardiography and Exercise-Redistribution-Reinjection Thallium SPECT Circulation, November 1, 1995; 92(9): 37 - 44. [Abstract] [Full Text]

				A. Maes, F. Van de Werf, J. Nuyts, G. Bormans, W. Desmet, and L. Mortelmans Impaired Myocardial Tissue Perfusion Early After Successful Thrombolysis : Impact on Myocardial Flow, Metabolism, and Function at Late Follow-up Circulation, October 15, 1995; 92(8): 2072 - 2078. [Abstract] [Full Text]

				C. Chen, L. Li, L. L. Chen, J. V. Prada, M. H. Chen, J. T. Fallon, A. E. Weyman, D. Waters, and L. Gillam Incremental Doses of Dobutamine Induce a Biphasic Response in Dysfunctional Left Ventricular Regions Subtending Coronary Stenoses Circulation, August 15, 1995; 92(4): 756 - 766. [Abstract] [Full Text]

				V. Sansoy, D. K. Glover, D. D. Watson, M. Ruiz, W. H. Smith, J. P. Simanis, and G. A. Beller Comparison of Thallium-201 Resting Redistribution With Technetium-99m–Sestamibi Uptake and Functional Response to Dobutamine for Assessment of Myocardial Viability Circulation, August 15, 1995; 92(4): 994 - 1004. [Abstract] [Full Text]

				M. Arnese, J. H. Cornel, A. Salustri, A. P.W.M. Maat, A. Elhendy, A. E.M. Reijs, F. J. Ten Cate, D. Keane, A. H.M.M. Balk, J. R.T.C. Roelandt, et al. Prediction of Improvement of Regional Left Ventricular Function After Surgical Revascularization : A Comparison of Low-Dose Dobutamine Echocardiography With 201Tl Single-Photon Emission Computed Tomography Circulation, June 1, 1995; 91(11): 2748 - 2752. [Abstract] [Full Text]

				P. Perrone-Filardi, L. Pace, M. Prastaro, F. Piscione, S. Betocchi, F. Squame, P. Vezzuto, A. Soricelli, C. Indolfi, M. Salvatore, et al. Dobutamine Echocardiography Predicts Improvement of Hypoperfused Dysfunctional Myocardium After Revascularization in Patients With Coronary Artery Disease Circulation, May 15, 1995; 91(10): 2556 - 2565. [Abstract] [Full Text]

				N. Tamaki, M. Kawamoto, E. Tadamura, Y. Magata, Y. Yonekura, R. Nohara, S. Sasayama, K. Nishimura, T. Ban, and J. Konishi Prediction of ReversibleIschemia After Revascularization : Perfusion and Metabolic Studies WithPositron Emission Tomography Circulation, March 15, 1995; 91(6): 1697 - 1705. [Abstract] [Full Text]

				F. M. Baer, E. Voth, C. A. Schneider, P. Theissen, H. Schicha, and U. Sechtem Comparison of Low-Dose Dobutamine–Gradient-Echo Magnetic Resonance Imaging and Positron Emission Tomography With [18F]Fluorodeoxyglucose in Patients With Chronic Coronary Artery Disease : A Functional and Morphological Approach to the Detection of Residual Myocardial Viability Circulation, February 15, 1995; 91(4): 1006 - 1015. [Abstract] [Full Text]

				I. Afridi, N. S. Kleiman, A. E. Raizner, and W. A. Zoghbi Dobutamine Echocardiography in Myocardial Hibernation : Optimal Dose and Accuracy in Predicting Recovery of Ventricular Function After Coronary Angioplasty Circulation, February 1, 1995; 91(3): 663 - 670. [Abstract] [Full Text]

				E. C. Madu, W. Ahmar, J. Arthur, and T. D. Fraker Jr Clinical Utility of Digital Dobutamine Stress Echocardiography in the Noninvasive Evaluation of Coronary Artery Disease Arch Intern Med, May 23, 1994; 154(10): 1065 - 1072. [Abstract] [PDF]