Predictive value of dobutamine radionuclide ventriculography in detection of functional improvement after acute anterior wall infarction and thrombolytic therapy
Background: Prolonged postischemic ventricular dysfunction (stunned myocardium) may prevent the assessment of myocardial salvage early after thrombolysis. Dobutamine in conjunction with radionuclide ventriculography has been proposed for the early assessment of myocardial viability and prediction of...
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| Veröffentlicht in: | Clinical cardiology (Mahwah, N.J.) N.J.), 1997-03, Vol.20 (3), p.213-218 |
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| container_title | Clinical cardiology (Mahwah, N.J.) |
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| creator | Zafrir, Nili Bassevich, Roni Zlotikamien, Bruria Sulkes, Jaqueline Sclarovsky, Shmuel Lubin, Ernesto |
| description | Background: Prolonged postischemic ventricular dysfunction (stunned myocardium) may prevent the assessment of myocardial salvage early after thrombolysis. Dobutamine in conjunction with radionuclide ventriculography has been proposed for the early assessment of myocardial viability and prediction of functional recovery.
Hypothesis: This study was designed to investigate the effects of low‐dose dobutamine infusion on early global and regional function of reperfused myocardium after acute anterior wall myocardial infarction (MI). In particular, our purpose was to examine whether this response can predict late recovery of left ventricular function and correlate with the reperfused status (patency of infarct‐related artery).
Methods: In all, 29 consecutive patients with first uncomplicated anterior wall MI, and who had received thrombolytic therapy, underwent radionuclide ventriculography at rest and 2 min after each dose increment of dobutamine infusion (5–15 m̈g/kg/min) on the third day after the infarction, at discharge, and at 3 months' follow‐up. Global and regional ejection fraction were calculated at each stage. Four patients with complications were dropped from the study. A significant response to dobutamine was defined as an increase of at least ≥7% in global or regional ejection fraction at the infarct zones.
Results: Of the 25 patients, 18 (72%) fulfilled these criteria. Of these, 10 patients (56%) had a significant improvement in global or regional ejection fraction at discharge and 13 patients (72%) at 3‐month follow‐up. The overall sensitivity of the dobutamine test in predicting left ventricular improvement was 100% at discharge and 93% at 3‐month follow‐up. However, the positive and negative predictive values were 56 and 100% at discharge and 72 and 86%, respectively, at 3‐month follow‐up.
Conclusion: Low‐dose dobutamine radionuclide ventriculography is a safe and useful test for assessing myocardial viability and may predict late functional improvement in patients with anterior wall MI. |
| doi_str_mv | 10.1002/clc.4960200306 |
| format | Article |
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Hypothesis: This study was designed to investigate the effects of low‐dose dobutamine infusion on early global and regional function of reperfused myocardium after acute anterior wall myocardial infarction (MI). In particular, our purpose was to examine whether this response can predict late recovery of left ventricular function and correlate with the reperfused status (patency of infarct‐related artery).
Methods: In all, 29 consecutive patients with first uncomplicated anterior wall MI, and who had received thrombolytic therapy, underwent radionuclide ventriculography at rest and 2 min after each dose increment of dobutamine infusion (5–15 m̈g/kg/min) on the third day after the infarction, at discharge, and at 3 months' follow‐up. Global and regional ejection fraction were calculated at each stage. Four patients with complications were dropped from the study. A significant response to dobutamine was defined as an increase of at least ≥7% in global or regional ejection fraction at the infarct zones.
Results: Of the 25 patients, 18 (72%) fulfilled these criteria. Of these, 10 patients (56%) had a significant improvement in global or regional ejection fraction at discharge and 13 patients (72%) at 3‐month follow‐up. The overall sensitivity of the dobutamine test in predicting left ventricular improvement was 100% at discharge and 93% at 3‐month follow‐up. However, the positive and negative predictive values were 56 and 100% at discharge and 72 and 86%, respectively, at 3‐month follow‐up.
Conclusion: Low‐dose dobutamine radionuclide ventriculography is a safe and useful test for assessing myocardial viability and may predict late functional improvement in patients with anterior wall MI.</description><identifier>ISSN: 0160-9289</identifier><identifier>EISSN: 1932-8737</identifier><identifier>DOI: 10.1002/clc.4960200306</identifier><identifier>PMID: 9068905</identifier><identifier>CODEN: CLCADC</identifier><language>eng</language><publisher>New York: Wiley Periodicals, Inc</publisher><subject>acute anterior wall infarction ; Biological and medical sciences ; Cardiology. Vascular system ; Clinical Investigation ; Coronary heart disease ; Dobutamine ; Female ; functional improvement ; Heart ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - diagnostic imaging ; Myocardial Infarction - drug therapy ; Myocardial Infarction - physiopathology ; Predictive Value of Tests ; Prognosis ; Radionuclide Ventriculography ; Sensitivity and Specificity ; Stroke Volume ; Thrombolytic Therapy ; Treatment Outcome ; Ventricular Function, Left</subject><ispartof>Clinical cardiology (Mahwah, N.J.), 1997-03, Vol.20 (3), p.213-218</ispartof><rights>Copyright © 1997 Wiley Periodicals, Inc.</rights><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4646-f9e969b5ff8c3ab88cfd154171915095dedc6a4ee28e0bf8e8bac22ad3f5330b3</citedby><cites>FETCH-LOGICAL-c4646-f9e969b5ff8c3ab88cfd154171915095dedc6a4ee28e0bf8e8bac22ad3f5330b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6656290/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6656290/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,1411,27901,27902,45550,45551,53766,53768</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2603929$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9068905$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zafrir, Nili</creatorcontrib><creatorcontrib>Bassevich, Roni</creatorcontrib><creatorcontrib>Zlotikamien, Bruria</creatorcontrib><creatorcontrib>Sulkes, Jaqueline</creatorcontrib><creatorcontrib>Sclarovsky, Shmuel</creatorcontrib><creatorcontrib>Lubin, Ernesto</creatorcontrib><title>Predictive value of dobutamine radionuclide ventriculography in detection of functional improvement after acute anterior wall infarction and thrombolytic therapy</title><title>Clinical cardiology (Mahwah, N.J.)</title><addtitle>Clin Cardiol</addtitle><description>Background: Prolonged postischemic ventricular dysfunction (stunned myocardium) may prevent the assessment of myocardial salvage early after thrombolysis. Dobutamine in conjunction with radionuclide ventriculography has been proposed for the early assessment of myocardial viability and prediction of functional recovery.
Hypothesis: This study was designed to investigate the effects of low‐dose dobutamine infusion on early global and regional function of reperfused myocardium after acute anterior wall myocardial infarction (MI). In particular, our purpose was to examine whether this response can predict late recovery of left ventricular function and correlate with the reperfused status (patency of infarct‐related artery).
Methods: In all, 29 consecutive patients with first uncomplicated anterior wall MI, and who had received thrombolytic therapy, underwent radionuclide ventriculography at rest and 2 min after each dose increment of dobutamine infusion (5–15 m̈g/kg/min) on the third day after the infarction, at discharge, and at 3 months' follow‐up. Global and regional ejection fraction were calculated at each stage. Four patients with complications were dropped from the study. A significant response to dobutamine was defined as an increase of at least ≥7% in global or regional ejection fraction at the infarct zones.
Results: Of the 25 patients, 18 (72%) fulfilled these criteria. Of these, 10 patients (56%) had a significant improvement in global or regional ejection fraction at discharge and 13 patients (72%) at 3‐month follow‐up. The overall sensitivity of the dobutamine test in predicting left ventricular improvement was 100% at discharge and 93% at 3‐month follow‐up. However, the positive and negative predictive values were 56 and 100% at discharge and 72 and 86%, respectively, at 3‐month follow‐up.
Conclusion: Low‐dose dobutamine radionuclide ventriculography is a safe and useful test for assessing myocardial viability and may predict late functional improvement in patients with anterior wall MI.</description><subject>acute anterior wall infarction</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Clinical Investigation</subject><subject>Coronary heart disease</subject><subject>Dobutamine</subject><subject>Female</subject><subject>functional improvement</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial Infarction - drug therapy</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Radionuclide Ventriculography</subject><subject>Sensitivity and Specificity</subject><subject>Stroke Volume</subject><subject>Thrombolytic Therapy</subject><subject>Treatment Outcome</subject><subject>Ventricular Function, Left</subject><issn>0160-9289</issn><issn>1932-8737</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUGP0zAQhSMEWroLV25IPiBuKY6TOPYFCVULi1QJDnC2Js54a-TYxU66ys_hn-LSqiwnTh5rvjdvRq8oXlV0XVHK3mmn143klFFaU_6kWFWyZqXo6u5psaIVp6VkQj4vrlP6kXkqWH1VXEnKhaTtqvj1NeJg9WQPSA7gZiTBkCH08wSj9UgiDDb4WTs7ZAD9FK2eXbiPsN8txHoy4IRZHvxRaGb_pwZH7LiP4YBjlhAwE0YCep6QgM-1DZE8gMuUNxBPcvADmXYxjH1wy2R1_mB2WV4Uzwy4hC_P703x_ePtt81duf3y6fPmw7bUDW94aSRKLvvWGKFr6IXQZqjapuoqWbVUtgMOmkODyATS3ggUPWjGYKhNW9e0r2-K96e5-7kfM3y8FZzaRztCXFQAq_7teLtT9-GgOG85kzQPeHseEMPPGdOkRps0Ogcew5xUJ0THGsozuD6BOoaUIpqLSUXVMVSVQ1V_Q82C149Xu-DnFHP_zbkPSYMzEby26YIxTmvJZMbkCXuwDpf_mKrNdvNohd8pLsJc</recordid><startdate>199703</startdate><enddate>199703</enddate><creator>Zafrir, Nili</creator><creator>Bassevich, Roni</creator><creator>Zlotikamien, Bruria</creator><creator>Sulkes, Jaqueline</creator><creator>Sclarovsky, Shmuel</creator><creator>Lubin, Ernesto</creator><general>Wiley Periodicals, Inc</general><general>Wiley</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><scope>5PM</scope></search><sort><creationdate>199703</creationdate><title>Predictive value of dobutamine radionuclide ventriculography in detection of functional improvement after acute anterior wall infarction and thrombolytic therapy</title><author>Zafrir, Nili ; Bassevich, Roni ; Zlotikamien, Bruria ; Sulkes, Jaqueline ; Sclarovsky, Shmuel ; Lubin, Ernesto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4646-f9e969b5ff8c3ab88cfd154171915095dedc6a4ee28e0bf8e8bac22ad3f5330b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>acute anterior wall infarction</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Clinical Investigation</topic><topic>Coronary heart disease</topic><topic>Dobutamine</topic><topic>Female</topic><topic>functional improvement</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>Myocardial Infarction - drug therapy</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Radionuclide Ventriculography</topic><topic>Sensitivity and Specificity</topic><topic>Stroke Volume</topic><topic>Thrombolytic Therapy</topic><topic>Treatment Outcome</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zafrir, Nili</creatorcontrib><creatorcontrib>Bassevich, Roni</creatorcontrib><creatorcontrib>Zlotikamien, Bruria</creatorcontrib><creatorcontrib>Sulkes, Jaqueline</creatorcontrib><creatorcontrib>Sclarovsky, Shmuel</creatorcontrib><creatorcontrib>Lubin, Ernesto</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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zafrir, Nili</au><au>Bassevich, Roni</au><au>Zlotikamien, Bruria</au><au>Sulkes, Jaqueline</au><au>Sclarovsky, Shmuel</au><au>Lubin, Ernesto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive value of dobutamine radionuclide ventriculography in detection of functional improvement after acute anterior wall infarction and thrombolytic therapy</atitle><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle><addtitle>Clin Cardiol</addtitle><date>1997-03</date><risdate>1997</risdate><volume>20</volume><issue>3</issue><spage>213</spage><epage>218</epage><pages>213-218</pages><issn>0160-9289</issn><eissn>1932-8737</eissn><coden>CLCADC</coden><abstract>Background: Prolonged postischemic ventricular dysfunction (stunned myocardium) may prevent the assessment of myocardial salvage early after thrombolysis. Dobutamine in conjunction with radionuclide ventriculography has been proposed for the early assessment of myocardial viability and prediction of functional recovery.
Hypothesis: This study was designed to investigate the effects of low‐dose dobutamine infusion on early global and regional function of reperfused myocardium after acute anterior wall myocardial infarction (MI). In particular, our purpose was to examine whether this response can predict late recovery of left ventricular function and correlate with the reperfused status (patency of infarct‐related artery).
Methods: In all, 29 consecutive patients with first uncomplicated anterior wall MI, and who had received thrombolytic therapy, underwent radionuclide ventriculography at rest and 2 min after each dose increment of dobutamine infusion (5–15 m̈g/kg/min) on the third day after the infarction, at discharge, and at 3 months' follow‐up. Global and regional ejection fraction were calculated at each stage. Four patients with complications were dropped from the study. A significant response to dobutamine was defined as an increase of at least ≥7% in global or regional ejection fraction at the infarct zones.
Results: Of the 25 patients, 18 (72%) fulfilled these criteria. Of these, 10 patients (56%) had a significant improvement in global or regional ejection fraction at discharge and 13 patients (72%) at 3‐month follow‐up. The overall sensitivity of the dobutamine test in predicting left ventricular improvement was 100% at discharge and 93% at 3‐month follow‐up. However, the positive and negative predictive values were 56 and 100% at discharge and 72 and 86%, respectively, at 3‐month follow‐up.
Conclusion: Low‐dose dobutamine radionuclide ventriculography is a safe and useful test for assessing myocardial viability and may predict late functional improvement in patients with anterior wall MI.</abstract><cop>New York</cop><pub>Wiley Periodicals, Inc</pub><pmid>9068905</pmid><doi>10.1002/clc.4960200306</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical cardiology (Mahwah, N.J.), 1997-03, Vol.20 (3), p.213-218 |
| issn | 0160-9289 1932-8737 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | acute anterior wall infarction Biological and medical sciences Cardiology. Vascular system Clinical Investigation Coronary heart disease Dobutamine Female functional improvement Heart Humans Male Medical sciences Middle Aged Myocardial Infarction - diagnostic imaging Myocardial Infarction - drug therapy Myocardial Infarction - physiopathology Predictive Value of Tests Prognosis Radionuclide Ventriculography Sensitivity and Specificity Stroke Volume Thrombolytic Therapy Treatment Outcome Ventricular Function, Left |
| title | Predictive value of dobutamine radionuclide ventriculography in detection of functional improvement after acute anterior wall infarction and thrombolytic therapy |
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