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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

Jean-Luc Monin, MD^*, J.érôme Garot, MD^*, Marielle Scherrer-Crosbie, MD^*, Jean Rosso, MD^*, Anne-Marie Duval-Moulin, MD^*, Patrick Dupouy, MD, Emmanuel Teiger, MD, Alain Castaigne, MD^*, Jean-Claude Cachin, MD^*, Jean-Luc Dubois-Rande, MD, PhD^* and Pascal Gueret, MD, FACC^*

^* Fédération de Cardiologie, Hôpital Henri Mondor, 51 Avenue Maréchal De Lattre de Tassigny, 94010, Créteil, France
Service des Explorations Fonctionnelles, Hôpital Henri Mondor, AP-HP, 51 Avenue Maréchal De Lattre de Tassigny, 94010, Créteil, France

View larger version (19K): [in a new window]   Figure 1 Three patterns observed at dobutamine echocardiography and relationship between patency of infarct-related vessel at follow-up examination and recovery of LV function. Biphasic = biphasic response; No recov. = no functional recovery; Patent = patent infarct vessel at follow-up; Recov = functional recovery; Reocc = reoccluded infarct vessel at follow-up; Sustained imp. = sustained improvement.

View larger version (13K): [in a new window]   Figure 2 Influence of long-term vessel patency on WMSI in viable patients after revascularization. FU = follow-up; Viable all = all patients with myocardial viability at DSE; Viable + patent = patients with viable myocardium at DSE and patent IRA at follow-up; Viab + reocc = patients with viable myocardium at DSE and a reoccluded IRA at follow-up; WMSI: echographic wall motion score index. Data are shown as mean value ± SD. *p = 0.0001. Solid bars = baseline WMSI; open bars = follow-up WMSI.

View larger version (15K): [in a new window]   Figure 3 Influence of long-term vessel patency on global LVEF in viable patients after revascularization. LVEF = left ventricular ejection fraction; Viable all = all patients with myocardial viability at DSE; Viable + patent = patients with viable myocardium at DSE and patent IRA at follow-up; Viab + reocc = patients with viable myocardium at DSE and a reoccluded IRA at follow-up. Data are shown as mean value ± SD. *p = 0.02, **p = 0.0004. Solid bars = baseline LVEF; open bars = follow-up LVEF.