Comparison of real-time contrast echocardiography and low-dose dobutamine stress echocardiography in predicting the left ventricular functional recovery in patients after acute myocardial infarction under different therapeutic intervention

Wei Chun Huang, Kuan Rau Chiou, Chun Peng Liu, Shoa Lin Lin, Doyal Lee, Guang Yuan Mar, Shih Hung Hsiao, Ming Ho Kung, Chuen Wang Chiou, Tzu Wen Lin

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Abstract

Background: Early prediction of left ventricular (LV) functional recovery after acute myocardial infarction (AMI) remains challenging. This prospective study aims to compare real-time myocardial contrast echocardiography (MCE) with low-dose dobutamine stress echocardiography (LDDSE) in predicting the LV functional recovery in patients after AMI who underwent different therapeutic interventions. Methods: Ninety-two patients with AMI were divided into 3 groups: primary coronary intervention group (n=34), thrombolysis group (n=30) and conservative therapy group (n=28). MCE was performed 2.3±0.7 days after chest pain onset. LDDSE was done within 2 days of MCE study. Follow-up echocardiography was performed 4 months later. Results: Patients treated by primary coronary intervention or thrombolysis had significantly lower regional perfusion score (0.65±0.53 vs. 1.01±0.49, p=0.008; 0.78±0.55 vs. 1.01±0.49, p=0.03), better contractile reserve (regional dobutamine Δwall motion score -1.12±0.39 vs. -0.80±0.43, p=0.01; -0.99±0.50 vs. -0.80±0.43, p=0.08) and LV function recovery (regional Δwall motion score -1.67±0.53 vs. -1.02±0.46, p=0.003; -1.42±0.58 vs. -1.02±0.46, p=0.03) than those of conservative therapy group. MCE and LDDSE showed good concordance for predicting LV functional recovery (kappa=0.63, p<0.001). Perfusion score index had a good correlation with LV functional recovery (r=-0.75, p<0.001). Conclusions: This study demonstrates that perfusion score index obtained from real-time MCE is comparable to LDDSE in predicting the LV functional recovery even under different therapeutic interventions. Revascularization results in better preservation of myocardial microvascular integrity, regional contractile reserve and LV functional recovery.

Original languageEnglish
Pages (from-to)81-91
Number of pages11
JournalInternational Journal of Cardiology
Volume104
Issue number1
DOIs
Publication statusPublished - Sep 15 2005
Externally publishedYes

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Stress Echocardiography
Echocardiography
Myocardial Infarction
Perfusion
Therapeutics
Dobutamine
Chest Pain
Left Ventricular Function
Prospective Studies

Keywords

  • Acute myocardial infarction
  • Low-dose dobutamine stress echocardiography
  • Myocardial contrast echocardiography
  • Primary coronary intervention
  • Thrombolysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of real-time contrast echocardiography and low-dose dobutamine stress echocardiography in predicting the left ventricular functional recovery in patients after acute myocardial infarction under different therapeutic intervention. / Huang, Wei Chun; Chiou, Kuan Rau; Liu, Chun Peng; Lin, Shoa Lin; Lee, Doyal; Mar, Guang Yuan; Hsiao, Shih Hung; Kung, Ming Ho; Chiou, Chuen Wang; Lin, Tzu Wen.

In: International Journal of Cardiology, Vol. 104, No. 1, 15.09.2005, p. 81-91.

Research output: Contribution to journalArticle

Huang, Wei Chun ; Chiou, Kuan Rau ; Liu, Chun Peng ; Lin, Shoa Lin ; Lee, Doyal ; Mar, Guang Yuan ; Hsiao, Shih Hung ; Kung, Ming Ho ; Chiou, Chuen Wang ; Lin, Tzu Wen. / Comparison of real-time contrast echocardiography and low-dose dobutamine stress echocardiography in predicting the left ventricular functional recovery in patients after acute myocardial infarction under different therapeutic intervention. In: International Journal of Cardiology. 2005 ; Vol. 104, No. 1. pp. 81-91.
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abstract = "Background: Early prediction of left ventricular (LV) functional recovery after acute myocardial infarction (AMI) remains challenging. This prospective study aims to compare real-time myocardial contrast echocardiography (MCE) with low-dose dobutamine stress echocardiography (LDDSE) in predicting the LV functional recovery in patients after AMI who underwent different therapeutic interventions. Methods: Ninety-two patients with AMI were divided into 3 groups: primary coronary intervention group (n=34), thrombolysis group (n=30) and conservative therapy group (n=28). MCE was performed 2.3±0.7 days after chest pain onset. LDDSE was done within 2 days of MCE study. Follow-up echocardiography was performed 4 months later. Results: Patients treated by primary coronary intervention or thrombolysis had significantly lower regional perfusion score (0.65±0.53 vs. 1.01±0.49, p=0.008; 0.78±0.55 vs. 1.01±0.49, p=0.03), better contractile reserve (regional dobutamine Δwall motion score -1.12±0.39 vs. -0.80±0.43, p=0.01; -0.99±0.50 vs. -0.80±0.43, p=0.08) and LV function recovery (regional Δwall motion score -1.67±0.53 vs. -1.02±0.46, p=0.003; -1.42±0.58 vs. -1.02±0.46, p=0.03) than those of conservative therapy group. MCE and LDDSE showed good concordance for predicting LV functional recovery (kappa=0.63, p<0.001). Perfusion score index had a good correlation with LV functional recovery (r=-0.75, p<0.001). Conclusions: This study demonstrates that perfusion score index obtained from real-time MCE is comparable to LDDSE in predicting the LV functional recovery even under different therapeutic interventions. Revascularization results in better preservation of myocardial microvascular integrity, regional contractile reserve and LV functional recovery.",
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author = "Huang, {Wei Chun} and Chiou, {Kuan Rau} and Liu, {Chun Peng} and Lin, {Shoa Lin} and Doyal Lee and Mar, {Guang Yuan} and Hsiao, {Shih Hung} and Kung, {Ming Ho} and Chiou, {Chuen Wang} and Lin, {Tzu Wen}",
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T1 - Comparison of real-time contrast echocardiography and low-dose dobutamine stress echocardiography in predicting the left ventricular functional recovery in patients after acute myocardial infarction under different therapeutic intervention

AU - Huang, Wei Chun

AU - Chiou, Kuan Rau

AU - Liu, Chun Peng

AU - Lin, Shoa Lin

AU - Lee, Doyal

AU - Mar, Guang Yuan

AU - Hsiao, Shih Hung

AU - Kung, Ming Ho

AU - Chiou, Chuen Wang

AU - Lin, Tzu Wen

PY - 2005/9/15

Y1 - 2005/9/15

N2 - Background: Early prediction of left ventricular (LV) functional recovery after acute myocardial infarction (AMI) remains challenging. This prospective study aims to compare real-time myocardial contrast echocardiography (MCE) with low-dose dobutamine stress echocardiography (LDDSE) in predicting the LV functional recovery in patients after AMI who underwent different therapeutic interventions. Methods: Ninety-two patients with AMI were divided into 3 groups: primary coronary intervention group (n=34), thrombolysis group (n=30) and conservative therapy group (n=28). MCE was performed 2.3±0.7 days after chest pain onset. LDDSE was done within 2 days of MCE study. Follow-up echocardiography was performed 4 months later. Results: Patients treated by primary coronary intervention or thrombolysis had significantly lower regional perfusion score (0.65±0.53 vs. 1.01±0.49, p=0.008; 0.78±0.55 vs. 1.01±0.49, p=0.03), better contractile reserve (regional dobutamine Δwall motion score -1.12±0.39 vs. -0.80±0.43, p=0.01; -0.99±0.50 vs. -0.80±0.43, p=0.08) and LV function recovery (regional Δwall motion score -1.67±0.53 vs. -1.02±0.46, p=0.003; -1.42±0.58 vs. -1.02±0.46, p=0.03) than those of conservative therapy group. MCE and LDDSE showed good concordance for predicting LV functional recovery (kappa=0.63, p<0.001). Perfusion score index had a good correlation with LV functional recovery (r=-0.75, p<0.001). Conclusions: This study demonstrates that perfusion score index obtained from real-time MCE is comparable to LDDSE in predicting the LV functional recovery even under different therapeutic interventions. Revascularization results in better preservation of myocardial microvascular integrity, regional contractile reserve and LV functional recovery.

AB - Background: Early prediction of left ventricular (LV) functional recovery after acute myocardial infarction (AMI) remains challenging. This prospective study aims to compare real-time myocardial contrast echocardiography (MCE) with low-dose dobutamine stress echocardiography (LDDSE) in predicting the LV functional recovery in patients after AMI who underwent different therapeutic interventions. Methods: Ninety-two patients with AMI were divided into 3 groups: primary coronary intervention group (n=34), thrombolysis group (n=30) and conservative therapy group (n=28). MCE was performed 2.3±0.7 days after chest pain onset. LDDSE was done within 2 days of MCE study. Follow-up echocardiography was performed 4 months later. Results: Patients treated by primary coronary intervention or thrombolysis had significantly lower regional perfusion score (0.65±0.53 vs. 1.01±0.49, p=0.008; 0.78±0.55 vs. 1.01±0.49, p=0.03), better contractile reserve (regional dobutamine Δwall motion score -1.12±0.39 vs. -0.80±0.43, p=0.01; -0.99±0.50 vs. -0.80±0.43, p=0.08) and LV function recovery (regional Δwall motion score -1.67±0.53 vs. -1.02±0.46, p=0.003; -1.42±0.58 vs. -1.02±0.46, p=0.03) than those of conservative therapy group. MCE and LDDSE showed good concordance for predicting LV functional recovery (kappa=0.63, p<0.001). Perfusion score index had a good correlation with LV functional recovery (r=-0.75, p<0.001). Conclusions: This study demonstrates that perfusion score index obtained from real-time MCE is comparable to LDDSE in predicting the LV functional recovery even under different therapeutic interventions. Revascularization results in better preservation of myocardial microvascular integrity, regional contractile reserve and LV functional recovery.

KW - Acute myocardial infarction

KW - Low-dose dobutamine stress echocardiography

KW - Myocardial contrast echocardiography

KW - Primary coronary intervention

KW - Thrombolysis

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