Predictive value of low dose dobutamine transesophageal echocardiography and fluorine-18 fluorodeoxyglucose positron emission tomography for recovery of regional left ventricular function after successful revascularization
Objectives. This study was designed to assess the predictive value of myocardial viability diagnosed by dobutamine transesophageal echocardiography and fluorine (F)-18 fluorodeoxyglucose positron emission tomography for left ventricular functional recovery after revascularization in patients with ch...
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| Veröffentlicht in: | Journal of the American College of Cardiology 1996-07, Vol.28 (1), p.60-69 |
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| creator | Baer, Frank M. Voth, Eberhard Deutsch, Hans J. Schneider, Christian A. Horst, Michael de Vivie, Ernst R. Schicha, Harald Erdmann, Erland Sechtem, Udo |
| description | Objectives. This study was designed to assess the predictive value of myocardial viability diagnosed by dobutamine transesophageal echocardiography and fluorine (F)-18 fluorodeoxyglucose positron emission tomography for left ventricular functional recovery after revascularization in patients with chronic left ventricular dysfunction.
Background. The identification of akinetic but viable myocardium is of particular importance for the selection of patients with a compromised left ventricle who will benefit from coronary revascularization.
Methods. Multiplane rest and dobutamine transesophageal echocardiography (dobutamine, 5 and 10 μg/min per kg) studies and F-18 fluorodeoxyglucose positron emission tomographic studies at rest were performed in 42 patients with 1) previous myocardial infarction and regional akinesia, 2) a stenosed infarct-related coronary artery, and 3) a patent infarct-related vessel after revascularization. A basally akinetic segment was considered viable by transesophageal echocardiography if dobutamine-induced contractile reserve could be observed. Viability by positron emission tomography was defined as F-18 fluorodeoxyglucose uptake ≥50% of the maximal uptake in a region with normal wall motion. Recovery of regional left ventricular function 4 t0 6 months after revascularization was diagnosed by transesophageal echocardiography if ≥50% of segments akinetic at baseline had improved wall thickening.
Results. Dobutamine transesophageal echocardiography identified viable infarct regions in 25 (59%) of 42 patients, and F-18 fluorodeoxyglucose positron emission tomography in 30 (71%) of 42 patients, yielding diagnostic agreement in 86% of patients. Sensitivity and specificity for prediction of left ventricular functional recovery in individual patients was 92% and 88%, respectively, for dobutamine transesophageal echocardiography versus 96% and 69% for F-18 fluorodeoxyglucose positron emission tomography. Segments remaining akinetic after revascularization had a significantly lower (p < 0.001) F-18 fluorodeoxyglucose uptake (48 ± 15%) than that (73 ± 15%) of segments with recovery of regional left ventricular function.
Conclusions. Both dobutamine transesophageal echocardiography and F-18 fluorodeoxyglucose positron emission tomography were highly sensitive in predicting functional recovery of chronically kinetic or dyskinetic myocardium after successful revascularization. Thus, dobutamine transesophageal echocardiography is a clinically val |
| doi_str_mv | 10.1016/0735-1097(96)00106-4 |
| format | Article |
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Background. The identification of akinetic but viable myocardium is of particular importance for the selection of patients with a compromised left ventricle who will benefit from coronary revascularization.
Methods. Multiplane rest and dobutamine transesophageal echocardiography (dobutamine, 5 and 10 μg/min per kg) studies and F-18 fluorodeoxyglucose positron emission tomographic studies at rest were performed in 42 patients with 1) previous myocardial infarction and regional akinesia, 2) a stenosed infarct-related coronary artery, and 3) a patent infarct-related vessel after revascularization. A basally akinetic segment was considered viable by transesophageal echocardiography if dobutamine-induced contractile reserve could be observed. Viability by positron emission tomography was defined as F-18 fluorodeoxyglucose uptake ≥50% of the maximal uptake in a region with normal wall motion. Recovery of regional left ventricular function 4 t0 6 months after revascularization was diagnosed by transesophageal echocardiography if ≥50% of segments akinetic at baseline had improved wall thickening.
Results. Dobutamine transesophageal echocardiography identified viable infarct regions in 25 (59%) of 42 patients, and F-18 fluorodeoxyglucose positron emission tomography in 30 (71%) of 42 patients, yielding diagnostic agreement in 86% of patients. Sensitivity and specificity for prediction of left ventricular functional recovery in individual patients was 92% and 88%, respectively, for dobutamine transesophageal echocardiography versus 96% and 69% for F-18 fluorodeoxyglucose positron emission tomography. Segments remaining akinetic after revascularization had a significantly lower (p < 0.001) F-18 fluorodeoxyglucose uptake (48 ± 15%) than that (73 ± 15%) of segments with recovery of regional left ventricular function.
Conclusions. Both dobutamine transesophageal echocardiography and F-18 fluorodeoxyglucose positron emission tomography were highly sensitive in predicting functional recovery of chronically kinetic or dyskinetic myocardium after successful revascularization. Thus, dobutamine transesophageal echocardiography is a clinically valuable alternative to F-18 fluorodeoxyglucose positron emission tomography for assessing residual viability and predicting functional recovery after revascularization.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/0735-1097(96)00106-4</identifier><identifier>PMID: 8752795</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adrenergic beta-Agonists ; Biological and medical sciences ; Cardiology. Vascular system ; Coronary heart disease ; Deoxyglucose - analogs & derivatives ; Dobutamine ; Echocardiography, Transesophageal - methods ; Female ; Fluorine Radioisotopes ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Heart ; Heart - diagnostic imaging ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - therapy ; Myocardial Revascularization - methods ; Predictive Value of Tests ; Prospective Studies ; Sensitivity and Specificity ; Time Factors ; Tomography, Emission-Computed ; Ventricular Dysfunction, Left - diagnosis ; Ventricular Dysfunction, Left - epidemiology ; Ventricular Function, Left - physiology</subject><ispartof>Journal of the American College of Cardiology, 1996-07, Vol.28 (1), p.60-69</ispartof><rights>1996</rights><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c531t-5edd3561b191ead957e2299e6bc7c44f183096145e9094d38bd7311c783071903</citedby><cites>FETCH-LOGICAL-c531t-5edd3561b191ead957e2299e6bc7c44f183096145e9094d38bd7311c783071903</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0735-1097(96)00106-4$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3153338$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8752795$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baer, Frank M.</creatorcontrib><creatorcontrib>Voth, Eberhard</creatorcontrib><creatorcontrib>Deutsch, Hans J.</creatorcontrib><creatorcontrib>Schneider, Christian A.</creatorcontrib><creatorcontrib>Horst, Michael</creatorcontrib><creatorcontrib>de Vivie, Ernst R.</creatorcontrib><creatorcontrib>Schicha, Harald</creatorcontrib><creatorcontrib>Erdmann, Erland</creatorcontrib><creatorcontrib>Sechtem, Udo</creatorcontrib><title>Predictive value of low dose dobutamine transesophageal echocardiography and fluorine-18 fluorodeoxyglucose positron emission tomography for recovery of regional left ventricular function after successful revascularization</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Objectives. This study was designed to assess the predictive value of myocardial viability diagnosed by dobutamine transesophageal echocardiography and fluorine (F)-18 fluorodeoxyglucose positron emission tomography for left ventricular functional recovery after revascularization in patients with chronic left ventricular dysfunction.
Background. The identification of akinetic but viable myocardium is of particular importance for the selection of patients with a compromised left ventricle who will benefit from coronary revascularization.
Methods. Multiplane rest and dobutamine transesophageal echocardiography (dobutamine, 5 and 10 μg/min per kg) studies and F-18 fluorodeoxyglucose positron emission tomographic studies at rest were performed in 42 patients with 1) previous myocardial infarction and regional akinesia, 2) a stenosed infarct-related coronary artery, and 3) a patent infarct-related vessel after revascularization. A basally akinetic segment was considered viable by transesophageal echocardiography if dobutamine-induced contractile reserve could be observed. Viability by positron emission tomography was defined as F-18 fluorodeoxyglucose uptake ≥50% of the maximal uptake in a region with normal wall motion. Recovery of regional left ventricular function 4 t0 6 months after revascularization was diagnosed by transesophageal echocardiography if ≥50% of segments akinetic at baseline had improved wall thickening.
Results. Dobutamine transesophageal echocardiography identified viable infarct regions in 25 (59%) of 42 patients, and F-18 fluorodeoxyglucose positron emission tomography in 30 (71%) of 42 patients, yielding diagnostic agreement in 86% of patients. Sensitivity and specificity for prediction of left ventricular functional recovery in individual patients was 92% and 88%, respectively, for dobutamine transesophageal echocardiography versus 96% and 69% for F-18 fluorodeoxyglucose positron emission tomography. Segments remaining akinetic after revascularization had a significantly lower (p < 0.001) F-18 fluorodeoxyglucose uptake (48 ± 15%) than that (73 ± 15%) of segments with recovery of regional left ventricular function.
Conclusions. Both dobutamine transesophageal echocardiography and F-18 fluorodeoxyglucose positron emission tomography were highly sensitive in predicting functional recovery of chronically kinetic or dyskinetic myocardium after successful revascularization. Thus, dobutamine transesophageal echocardiography is a clinically valuable alternative to F-18 fluorodeoxyglucose positron emission tomography for assessing residual viability and predicting functional recovery after revascularization.</description><subject>Adrenergic beta-Agonists</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Coronary heart disease</subject><subject>Deoxyglucose - analogs & derivatives</subject><subject>Dobutamine</subject><subject>Echocardiography, Transesophageal - methods</subject><subject>Female</subject><subject>Fluorine Radioisotopes</subject><subject>Fluorodeoxyglucose F18</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart - diagnostic imaging</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocardial Revascularization - methods</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Time Factors</subject><subject>Tomography, Emission-Computed</subject><subject>Ventricular Dysfunction, Left - diagnosis</subject><subject>Ventricular Dysfunction, Left - epidemiology</subject><subject>Ventricular Function, Left - physiology</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ksuuFCEQhjtGcxyPvoEmLIzRRSsMTdNsTMyJt-QkutA1oaGYwdDNyKV1fFifRdoZZ-kGCur7i4KfpnlM8EuCSf8Kc8paggV_LvoXGBPct92dZkMYG1rKBL_bbC7I_eZBSt8wxv1AxFVzNXC25YJtmt-fIxins1sALcoXQMEiH34gExLUYSxZTW4GlKOaE6Rw2KsdKI9A74NW0biwi-qwPyI1G2R9CbHSLRlOcTAQfh53vui13CEkl2OYEUwuJVeDHKZ_ehsiiqDDAvG4NhFhV4l6kgeb0QJzjk4XryKyZa4NV7WyGSJKRWtIyRZfNYtKfyH3S63Iw-aeVT7Bo_N83Xx99_bLzYf29tP7jzdvblvNKMktA2Mo68lIBAFlBOOw3QoB_ai57jpLBopFTzoGAovO0GE0nBKied3nRGB63Tw71T3E8L1AyrLeUIP3aoZQkuQD6YZu6CvYnUAdQ0oRrDxEN6l4lATL1Va5eiZXz6Soi9VW2VXZk3P9Mk5gLqKzjzX_9Jyv91feVrO0SxeMEkYpHSr2-oRBfYvFQZRJO5h1_QL16bM0wf2_jz9I08ZI</recordid><startdate>19960701</startdate><enddate>19960701</enddate><creator>Baer, Frank M.</creator><creator>Voth, Eberhard</creator><creator>Deutsch, Hans J.</creator><creator>Schneider, Christian A.</creator><creator>Horst, Michael</creator><creator>de Vivie, Ernst R.</creator><creator>Schicha, Harald</creator><creator>Erdmann, Erland</creator><creator>Sechtem, Udo</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><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>19960701</creationdate><title>Predictive value of low dose dobutamine transesophageal echocardiography and fluorine-18 fluorodeoxyglucose positron emission tomography for recovery of regional left ventricular function after successful revascularization</title><author>Baer, Frank M. ; Voth, Eberhard ; Deutsch, Hans J. ; Schneider, Christian A. ; Horst, Michael ; de Vivie, Ernst R. ; Schicha, Harald ; Erdmann, Erland ; Sechtem, Udo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c531t-5edd3561b191ead957e2299e6bc7c44f183096145e9094d38bd7311c783071903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adrenergic beta-Agonists</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Coronary heart disease</topic><topic>Deoxyglucose - analogs & derivatives</topic><topic>Dobutamine</topic><topic>Echocardiography, Transesophageal - methods</topic><topic>Female</topic><topic>Fluorine Radioisotopes</topic><topic>Fluorodeoxyglucose F18</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart - diagnostic imaging</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - therapy</topic><topic>Myocardial Revascularization - methods</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Time Factors</topic><topic>Tomography, Emission-Computed</topic><topic>Ventricular Dysfunction, Left - diagnosis</topic><topic>Ventricular Dysfunction, Left - epidemiology</topic><topic>Ventricular Function, Left - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baer, Frank M.</creatorcontrib><creatorcontrib>Voth, Eberhard</creatorcontrib><creatorcontrib>Deutsch, Hans J.</creatorcontrib><creatorcontrib>Schneider, Christian A.</creatorcontrib><creatorcontrib>Horst, Michael</creatorcontrib><creatorcontrib>de Vivie, Ernst R.</creatorcontrib><creatorcontrib>Schicha, Harald</creatorcontrib><creatorcontrib>Erdmann, Erland</creatorcontrib><creatorcontrib>Sechtem, Udo</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><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>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baer, Frank M.</au><au>Voth, Eberhard</au><au>Deutsch, Hans J.</au><au>Schneider, Christian A.</au><au>Horst, Michael</au><au>de Vivie, Ernst R.</au><au>Schicha, Harald</au><au>Erdmann, Erland</au><au>Sechtem, Udo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive value of low dose dobutamine transesophageal echocardiography and fluorine-18 fluorodeoxyglucose positron emission tomography for recovery of regional left ventricular function after successful revascularization</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1996-07-01</date><risdate>1996</risdate><volume>28</volume><issue>1</issue><spage>60</spage><epage>69</epage><pages>60-69</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>Objectives. This study was designed to assess the predictive value of myocardial viability diagnosed by dobutamine transesophageal echocardiography and fluorine (F)-18 fluorodeoxyglucose positron emission tomography for left ventricular functional recovery after revascularization in patients with chronic left ventricular dysfunction.
Background. The identification of akinetic but viable myocardium is of particular importance for the selection of patients with a compromised left ventricle who will benefit from coronary revascularization.
Methods. Multiplane rest and dobutamine transesophageal echocardiography (dobutamine, 5 and 10 μg/min per kg) studies and F-18 fluorodeoxyglucose positron emission tomographic studies at rest were performed in 42 patients with 1) previous myocardial infarction and regional akinesia, 2) a stenosed infarct-related coronary artery, and 3) a patent infarct-related vessel after revascularization. A basally akinetic segment was considered viable by transesophageal echocardiography if dobutamine-induced contractile reserve could be observed. Viability by positron emission tomography was defined as F-18 fluorodeoxyglucose uptake ≥50% of the maximal uptake in a region with normal wall motion. Recovery of regional left ventricular function 4 t0 6 months after revascularization was diagnosed by transesophageal echocardiography if ≥50% of segments akinetic at baseline had improved wall thickening.
Results. Dobutamine transesophageal echocardiography identified viable infarct regions in 25 (59%) of 42 patients, and F-18 fluorodeoxyglucose positron emission tomography in 30 (71%) of 42 patients, yielding diagnostic agreement in 86% of patients. Sensitivity and specificity for prediction of left ventricular functional recovery in individual patients was 92% and 88%, respectively, for dobutamine transesophageal echocardiography versus 96% and 69% for F-18 fluorodeoxyglucose positron emission tomography. Segments remaining akinetic after revascularization had a significantly lower (p < 0.001) F-18 fluorodeoxyglucose uptake (48 ± 15%) than that (73 ± 15%) of segments with recovery of regional left ventricular function.
Conclusions. Both dobutamine transesophageal echocardiography and F-18 fluorodeoxyglucose positron emission tomography were highly sensitive in predicting functional recovery of chronically kinetic or dyskinetic myocardium after successful revascularization. Thus, dobutamine transesophageal echocardiography is a clinically valuable alternative to F-18 fluorodeoxyglucose positron emission tomography for assessing residual viability and predicting functional recovery after revascularization.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>8752795</pmid><doi>10.1016/0735-1097(96)00106-4</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adrenergic beta-Agonists Biological and medical sciences Cardiology. Vascular system Coronary heart disease Deoxyglucose - analogs & derivatives Dobutamine Echocardiography, Transesophageal - methods Female Fluorine Radioisotopes Fluorodeoxyglucose F18 Follow-Up Studies Heart Heart - diagnostic imaging Humans Male Medical sciences Middle Aged Myocardial Infarction - therapy Myocardial Revascularization - methods Predictive Value of Tests Prospective Studies Sensitivity and Specificity Time Factors Tomography, Emission-Computed Ventricular Dysfunction, Left - diagnosis Ventricular Dysfunction, Left - epidemiology Ventricular Function, Left - physiology |
| title | Predictive value of low dose dobutamine transesophageal echocardiography and fluorine-18 fluorodeoxyglucose positron emission tomography for recovery of regional left ventricular function after successful revascularization |
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