Comparison between low-dose dobutamine echocardiography and thallium-201 scintigraphy in the detection of myocardial viability in patients with recent myocardial infarction
Aim: To compare the predictive value of thallium-201 single photon emission computed tomography (SPECT) scintigraphy (Sci) and low-dose dobutamine echocardiography (Dob) in predicting late recovery of dysfunctioning myocardium in patients with recent, uncomplicated myocardial infarction (MI). Method...
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| Veröffentlicht in: | International journal of cardiology 2000-05, Vol.73 (3), p.213-223 |
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| container_title | International journal of cardiology |
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| creator | Anselmi, Maurizio Golia, Giorgio Maines, Massimiliano Marino, Paolo Goj, Carlo Turri, Marco Cavaggioni, Marco Braggio, Paolo Giorgetti, Pier Giorgio Zardini, Piero |
| description | Aim: To compare the predictive value of thallium-201 single photon emission computed tomography (SPECT) scintigraphy (Sci) and low-dose dobutamine echocardiography (Dob) in predicting late recovery of dysfunctioning myocardium in patients with recent, uncomplicated myocardial infarction (MI).
Methods and results: 19 patients (18 male, aged 58±8 years) with recent MI and ejection fraction |
| doi_str_mv | 10.1016/S0167-5273(00)00215-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71170360</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0167527300002151</els_id><sourcerecordid>71170360</sourcerecordid><originalsourceid>FETCH-LOGICAL-c390t-73f3b73a0dc22ec69a83844325ee73cd39661854c6ef15b48a0b8445aad50efb3</originalsourceid><addsrcrecordid>eNqFkcuqFDEQhoMonnH0EZQsRHTRmnT6uhIZvMEBF-o6VCfVTkl3MibpM8w7-ZDmTA96dm4SQn31V6iPsadSvJZCNm--5qMt6rJVL4V4JUQp60LeYxvZtVUh27q6zzZ_kSv2KMafQoiq77uH7EqKrpJ9U27Y752fDxAoescHTEdExyd_LKyPyK0flgQzOeRo9t5AsOR_BDjsTxyc5WkP00TLXJRC8mjIJbpUyeViDsCEJlHO9iOfT2sCTPyGYKCJ0hk8QCJ0KfIjpT0PaPLjLkxuhHBOecwejDBFfHK5t-z7h_ffdp-K6y8fP-_eXRdG9SIVrRrV0CoQ1pQlmqaHTnVVpcoasVXGqr5pZFdXpsFR1kPVgRhyvQawtcBxUFv2Ys09BP9rwZj0TNHgNIFDv0TdStkK1YgM1itogo8x4KgPgWYIJy2FvtWkz5r0rQMthD5r0jL3PbsMWIYZ7Z2u1UsGnl8AiAamMYAzFP9xqm-7nLllb1cM8zZuCIPOFtAZtJT3mLT19J-f_AE9YrM-</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71170360</pqid></control><display><type>article</type><title>Comparison between low-dose dobutamine echocardiography and thallium-201 scintigraphy in the detection of myocardial viability in patients with recent myocardial infarction</title><source>MEDLINE</source><source>ScienceDirect Pay Per View(PPV) Titles</source><creator>Anselmi, Maurizio ; Golia, Giorgio ; Maines, Massimiliano ; Marino, Paolo ; Goj, Carlo ; Turri, Marco ; Cavaggioni, Marco ; Braggio, Paolo ; Giorgetti, Pier Giorgio ; Zardini, Piero</creator><creatorcontrib>Anselmi, Maurizio ; Golia, Giorgio ; Maines, Massimiliano ; Marino, Paolo ; Goj, Carlo ; Turri, Marco ; Cavaggioni, Marco ; Braggio, Paolo ; Giorgetti, Pier Giorgio ; Zardini, Piero</creatorcontrib><description>Aim: To compare the predictive value of thallium-201 single photon emission computed tomography (SPECT) scintigraphy (Sci) and low-dose dobutamine echocardiography (Dob) in predicting late recovery of dysfunctioning myocardium in patients with recent, uncomplicated myocardial infarction (MI).
Methods and results: 19 patients (18 male, aged 58±8 years) with recent MI and ejection fraction <50% (35.5±8.3%) underwent 5–15 μg/kg per min Dob, rest-redistribution Sci and coronary angiography, respectively, 14±6, 16±7 and 17±5 days after MI. On an eleven-segment ventricular model devised to compare Dob and Sci segment by segment, each dysfunctioning ventricular segment was considered viable if it showed recovery of mechanical function at the echocardiographic follow-up, performed 6.3±1.5 months after revascularization (five PTCA, five GABG) or medical therapy. Among the 104 dysfunctioning segments, of which 26 (25%) showed recovery at follow-up, Dob and Sci gave a concordant response in 50 (48%,
k=0.13), correctly predicting the recovery (or not) of function in 42. Forty-two of 54 discordant responses were due to segments judged viable only by Sci and which had no recovery at follow-up (of these 37 were akinetic or severely hypokinetic at baseline). At the segment-by-segment analysis, the sensitivity, specificity, and accuracy in predicting recovery of function at follow-up were, respectively, 69, 88 and 84% for Dob as against 88, 36 and 49% for Sci (
P<0.001 for both specificity and accuracy,
P=NS for sensitivity).
Conclusion: In patients with recent MI, the specificity of Dob in the detection of myocardium capable of late mechanical recovery is significantly higher with respect to Sci, whereas sensitivity is slightly, not significantly higher for the latter. It is conceivable that Sci detects viable myocardium even if it is transmurally limited to epicardial layers in segments with severely impaired mechanical function in which viability will not affect late recovery of function.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/S0167-5273(00)00215-1</identifier><identifier>PMID: 10841962</identifier><identifier>CODEN: IJCDD5</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Cardiotonic Agents ; Cardiovascular system ; Dobutamine ; Dobutamine echocardiography ; Female ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Myocardial infarction ; Myocardial Infarction - diagnosis ; Myocardial Infarction - diagnostic imaging ; Myocardial viability ; Predictive Value of Tests ; Radionuclide Imaging ; Sensitivity and Specificity ; Thallium Radioisotopes ; Ultrasonic investigative techniques ; Ultrasonography</subject><ispartof>International journal of cardiology, 2000-05, Vol.73 (3), p.213-223</ispartof><rights>2000 Elsevier Science Ireland Ltd</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-73f3b73a0dc22ec69a83844325ee73cd39661854c6ef15b48a0b8445aad50efb3</citedby><cites>FETCH-LOGICAL-c390t-73f3b73a0dc22ec69a83844325ee73cd39661854c6ef15b48a0b8445aad50efb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0167527300002151$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1397827$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10841962$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Anselmi, Maurizio</creatorcontrib><creatorcontrib>Golia, Giorgio</creatorcontrib><creatorcontrib>Maines, Massimiliano</creatorcontrib><creatorcontrib>Marino, Paolo</creatorcontrib><creatorcontrib>Goj, Carlo</creatorcontrib><creatorcontrib>Turri, Marco</creatorcontrib><creatorcontrib>Cavaggioni, Marco</creatorcontrib><creatorcontrib>Braggio, Paolo</creatorcontrib><creatorcontrib>Giorgetti, Pier Giorgio</creatorcontrib><creatorcontrib>Zardini, Piero</creatorcontrib><title>Comparison between low-dose dobutamine echocardiography and thallium-201 scintigraphy in the detection of myocardial viability in patients with recent myocardial infarction</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>Aim: To compare the predictive value of thallium-201 single photon emission computed tomography (SPECT) scintigraphy (Sci) and low-dose dobutamine echocardiography (Dob) in predicting late recovery of dysfunctioning myocardium in patients with recent, uncomplicated myocardial infarction (MI).
Methods and results: 19 patients (18 male, aged 58±8 years) with recent MI and ejection fraction <50% (35.5±8.3%) underwent 5–15 μg/kg per min Dob, rest-redistribution Sci and coronary angiography, respectively, 14±6, 16±7 and 17±5 days after MI. On an eleven-segment ventricular model devised to compare Dob and Sci segment by segment, each dysfunctioning ventricular segment was considered viable if it showed recovery of mechanical function at the echocardiographic follow-up, performed 6.3±1.5 months after revascularization (five PTCA, five GABG) or medical therapy. Among the 104 dysfunctioning segments, of which 26 (25%) showed recovery at follow-up, Dob and Sci gave a concordant response in 50 (48%,
k=0.13), correctly predicting the recovery (or not) of function in 42. Forty-two of 54 discordant responses were due to segments judged viable only by Sci and which had no recovery at follow-up (of these 37 were akinetic or severely hypokinetic at baseline). At the segment-by-segment analysis, the sensitivity, specificity, and accuracy in predicting recovery of function at follow-up were, respectively, 69, 88 and 84% for Dob as against 88, 36 and 49% for Sci (
P<0.001 for both specificity and accuracy,
P=NS for sensitivity).
Conclusion: In patients with recent MI, the specificity of Dob in the detection of myocardium capable of late mechanical recovery is significantly higher with respect to Sci, whereas sensitivity is slightly, not significantly higher for the latter. It is conceivable that Sci detects viable myocardium even if it is transmurally limited to epicardial layers in segments with severely impaired mechanical function in which viability will not affect late recovery of function.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiotonic Agents</subject><subject>Cardiovascular system</subject><subject>Dobutamine</subject><subject>Dobutamine echocardiography</subject><subject>Female</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial viability</subject><subject>Predictive Value of Tests</subject><subject>Radionuclide Imaging</subject><subject>Sensitivity and Specificity</subject><subject>Thallium Radioisotopes</subject><subject>Ultrasonic investigative techniques</subject><subject>Ultrasonography</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcuqFDEQhoMonnH0EZQsRHTRmnT6uhIZvMEBF-o6VCfVTkl3MibpM8w7-ZDmTA96dm4SQn31V6iPsadSvJZCNm--5qMt6rJVL4V4JUQp60LeYxvZtVUh27q6zzZ_kSv2KMafQoiq77uH7EqKrpJ9U27Y752fDxAoescHTEdExyd_LKyPyK0flgQzOeRo9t5AsOR_BDjsTxyc5WkP00TLXJRC8mjIJbpUyeViDsCEJlHO9iOfT2sCTPyGYKCJ0hk8QCJ0KfIjpT0PaPLjLkxuhHBOecwejDBFfHK5t-z7h_ffdp-K6y8fP-_eXRdG9SIVrRrV0CoQ1pQlmqaHTnVVpcoasVXGqr5pZFdXpsFR1kPVgRhyvQawtcBxUFv2Ys09BP9rwZj0TNHgNIFDv0TdStkK1YgM1itogo8x4KgPgWYIJy2FvtWkz5r0rQMthD5r0jL3PbsMWIYZ7Z2u1UsGnl8AiAamMYAzFP9xqm-7nLllb1cM8zZuCIPOFtAZtJT3mLT19J-f_AE9YrM-</recordid><startdate>20000531</startdate><enddate>20000531</enddate><creator>Anselmi, Maurizio</creator><creator>Golia, Giorgio</creator><creator>Maines, Massimiliano</creator><creator>Marino, Paolo</creator><creator>Goj, Carlo</creator><creator>Turri, Marco</creator><creator>Cavaggioni, Marco</creator><creator>Braggio, Paolo</creator><creator>Giorgetti, Pier Giorgio</creator><creator>Zardini, Piero</creator><general>Elsevier Ireland Ltd</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000531</creationdate><title>Comparison between low-dose dobutamine echocardiography and thallium-201 scintigraphy in the detection of myocardial viability in patients with recent myocardial infarction</title><author>Anselmi, Maurizio ; Golia, Giorgio ; Maines, Massimiliano ; Marino, Paolo ; Goj, Carlo ; Turri, Marco ; Cavaggioni, Marco ; Braggio, Paolo ; Giorgetti, Pier Giorgio ; Zardini, Piero</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-73f3b73a0dc22ec69a83844325ee73cd39661854c6ef15b48a0b8445aad50efb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiotonic Agents</topic><topic>Cardiovascular system</topic><topic>Dobutamine</topic><topic>Dobutamine echocardiography</topic><topic>Female</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>Myocardial viability</topic><topic>Predictive Value of Tests</topic><topic>Radionuclide Imaging</topic><topic>Sensitivity and Specificity</topic><topic>Thallium Radioisotopes</topic><topic>Ultrasonic investigative techniques</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anselmi, Maurizio</creatorcontrib><creatorcontrib>Golia, Giorgio</creatorcontrib><creatorcontrib>Maines, Massimiliano</creatorcontrib><creatorcontrib>Marino, Paolo</creatorcontrib><creatorcontrib>Goj, Carlo</creatorcontrib><creatorcontrib>Turri, Marco</creatorcontrib><creatorcontrib>Cavaggioni, Marco</creatorcontrib><creatorcontrib>Braggio, Paolo</creatorcontrib><creatorcontrib>Giorgetti, Pier Giorgio</creatorcontrib><creatorcontrib>Zardini, Piero</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anselmi, Maurizio</au><au>Golia, Giorgio</au><au>Maines, Massimiliano</au><au>Marino, Paolo</au><au>Goj, Carlo</au><au>Turri, Marco</au><au>Cavaggioni, Marco</au><au>Braggio, Paolo</au><au>Giorgetti, Pier Giorgio</au><au>Zardini, Piero</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison between low-dose dobutamine echocardiography and thallium-201 scintigraphy in the detection of myocardial viability in patients with recent myocardial infarction</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2000-05-31</date><risdate>2000</risdate><volume>73</volume><issue>3</issue><spage>213</spage><epage>223</epage><pages>213-223</pages><issn>0167-5273</issn><eissn>1874-1754</eissn><coden>IJCDD5</coden><abstract>Aim: To compare the predictive value of thallium-201 single photon emission computed tomography (SPECT) scintigraphy (Sci) and low-dose dobutamine echocardiography (Dob) in predicting late recovery of dysfunctioning myocardium in patients with recent, uncomplicated myocardial infarction (MI).
Methods and results: 19 patients (18 male, aged 58±8 years) with recent MI and ejection fraction <50% (35.5±8.3%) underwent 5–15 μg/kg per min Dob, rest-redistribution Sci and coronary angiography, respectively, 14±6, 16±7 and 17±5 days after MI. On an eleven-segment ventricular model devised to compare Dob and Sci segment by segment, each dysfunctioning ventricular segment was considered viable if it showed recovery of mechanical function at the echocardiographic follow-up, performed 6.3±1.5 months after revascularization (five PTCA, five GABG) or medical therapy. Among the 104 dysfunctioning segments, of which 26 (25%) showed recovery at follow-up, Dob and Sci gave a concordant response in 50 (48%,
k=0.13), correctly predicting the recovery (or not) of function in 42. Forty-two of 54 discordant responses were due to segments judged viable only by Sci and which had no recovery at follow-up (of these 37 were akinetic or severely hypokinetic at baseline). At the segment-by-segment analysis, the sensitivity, specificity, and accuracy in predicting recovery of function at follow-up were, respectively, 69, 88 and 84% for Dob as against 88, 36 and 49% for Sci (
P<0.001 for both specificity and accuracy,
P=NS for sensitivity).
Conclusion: In patients with recent MI, the specificity of Dob in the detection of myocardium capable of late mechanical recovery is significantly higher with respect to Sci, whereas sensitivity is slightly, not significantly higher for the latter. It is conceivable that Sci detects viable myocardium even if it is transmurally limited to epicardial layers in segments with severely impaired mechanical function in which viability will not affect late recovery of function.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>10841962</pmid><doi>10.1016/S0167-5273(00)00215-1</doi><tpages>11</tpages></addata></record> |
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| subjects | Adult Aged Biological and medical sciences Cardiotonic Agents Cardiovascular system Dobutamine Dobutamine echocardiography Female Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Myocardial infarction Myocardial Infarction - diagnosis Myocardial Infarction - diagnostic imaging Myocardial viability Predictive Value of Tests Radionuclide Imaging Sensitivity and Specificity Thallium Radioisotopes Ultrasonic investigative techniques Ultrasonography |
| title | Comparison between low-dose dobutamine echocardiography and thallium-201 scintigraphy in the detection of myocardial viability in patients with recent myocardial infarction |
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