open access

Vol 63, No 12 (2005)
Other
Published online: 2005-12-14
Submitted: 2012-12-28
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ORIGINAL ARTICLE
The prognostic significance of early dobutamine echocardiography in patients with acute myocardial infarction treated with primary coronary angioplasty

Anna Tomaszuk-Kazberuk, Włodzimierz J. Musiał, Sławomir Dobrzycki, Janusz Korecki
Kardiol Pol 2005;63(12):613-619.

open access

Vol 63, No 12 (2005)
Other
Published online: 2005-12-14
Submitted: 2012-12-28

Abstract

Background: The prognostic significance of early dobutamine echocardiography (DE) after successfully treated acute myocardial infarction (AMI) with primary coronary angioplasty (PTCA) is still unclear. Patients who respond to DE may have better left ventricular function improvement and possibly a better clinical outcome. Aim: To assess whether early DE can predict spontaneous functional recovery in patients treated successfully with primary PTCA and whether responders to DE have a better clinical outcome. Methods: DE (5 and 10 ug/kg/min) was performed in 110 consecutive patients (61±10 years) 4±1 days after successful primary PTCA (TIMI 3, stenosis <30%). Left ventricular ejection fraction (LVEF) and wall motion index (WMSI) were measured. Patients underwent clinical assessment and two-dimensional echocardiography at 3 and 6 months. Results: In the DE responders (76 pts), LVEF increased significantly from 41%±9% at baseline to 47%±10% at 6 months (p<0.0001), whereas the improvement found in nonresponders (34 pts) was insignificant (from 36.3%±9% at baseline to 38.8%±10% at 6 months, p=0.4). The nonresponders to DE had a higher incidence of subsequent revascularisation (4/34 (11.8%) vs 3/76 (3.9%) p=0.12), reinfarction (5/34 (14.7%) vs 2/76 (2.6%), p=0.28) and death (3/34 (9%) vs 0/76 (0%), p=0.0086). The incidence of combined end-point (revascularisation, reinfarction and death) was significantly lower in the group of responders to early DE (p=0.03). Conclusions: Early DE can precisely predict functional recovery and the extent of irreversibly damaged myocardium in patients with AMI in whom anterograde flow is fully restored. A positive response to early DE is associated with a better clinical outcome and prognosis.

Abstract

Background: The prognostic significance of early dobutamine echocardiography (DE) after successfully treated acute myocardial infarction (AMI) with primary coronary angioplasty (PTCA) is still unclear. Patients who respond to DE may have better left ventricular function improvement and possibly a better clinical outcome. Aim: To assess whether early DE can predict spontaneous functional recovery in patients treated successfully with primary PTCA and whether responders to DE have a better clinical outcome. Methods: DE (5 and 10 ug/kg/min) was performed in 110 consecutive patients (61±10 years) 4±1 days after successful primary PTCA (TIMI 3, stenosis <30%). Left ventricular ejection fraction (LVEF) and wall motion index (WMSI) were measured. Patients underwent clinical assessment and two-dimensional echocardiography at 3 and 6 months. Results: In the DE responders (76 pts), LVEF increased significantly from 41%±9% at baseline to 47%±10% at 6 months (p<0.0001), whereas the improvement found in nonresponders (34 pts) was insignificant (from 36.3%±9% at baseline to 38.8%±10% at 6 months, p=0.4). The nonresponders to DE had a higher incidence of subsequent revascularisation (4/34 (11.8%) vs 3/76 (3.9%) p=0.12), reinfarction (5/34 (14.7%) vs 2/76 (2.6%), p=0.28) and death (3/34 (9%) vs 0/76 (0%), p=0.0086). The incidence of combined end-point (revascularisation, reinfarction and death) was significantly lower in the group of responders to early DE (p=0.03). Conclusions: Early DE can precisely predict functional recovery and the extent of irreversibly damaged myocardium in patients with AMI in whom anterograde flow is fully restored. A positive response to early DE is associated with a better clinical outcome and prognosis.
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Keywords

acute myocardial infarction; primary coronary angioplasty; echocardiographic dobutamine test

About this article
Title

ORIGINAL ARTICLE
The prognostic significance of early dobutamine echocardiography in patients with acute myocardial infarction treated with primary coronary angioplasty

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 63, No 12 (2005)

Pages

613-619

Published online

2005-12-14

Bibliographic record

Kardiol Pol 2005;63(12):613-619.

Keywords

acute myocardial infarction
primary coronary angioplasty
echocardiographic dobutamine test

Authors

Anna Tomaszuk-Kazberuk
Włodzimierz J. Musiał
Sławomir Dobrzycki
Janusz Korecki

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