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Titolo:
Low dose dobutamine echo cardiography for predicting functional recovery after coronary revascularisation
Autore:
Piscione, F; Perrone-Filardi, P; De Luca, G; Prastaro, M; Indolfi, C; Golino, P; Dellegrottaglie, S; Chiariello, M;
Indirizzi:
Univ Naples Federico II, Div Cardiol, I-80131 Naples, Italy Univ Naples Federico II Naples Italy I-80131 diol, I-80131 Naples, Italy
Titolo Testata:
HEART
fascicolo: 6, volume: 86, anno: 2001,
pagine: 679 - 686
SICI:
1355-6037(200112)86:6<679:LDDECF>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR FUNCTION; MYOCARDIAL BLOOD-FLOW; ARTERY DISEASE; DYSFUNCTIONAL MYOCARDIUM; HIBERNATING MYOCARDIUM; REVERSIBLE DYSFUNCTION; BIPHASIC RESPONSE; TL-201 TOMOGRAPHY; ECHOCARDIOGRAPHY; VIABILITY;
Keywords:
dobutamine; coronary artery disease; viability; chronic occlusion;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Perrone-Filardi, P Univ Naples Federico II, Div Cardiol, Via Sergio Pansini 5, I-80131 Naples, Italy Univ Naples Federico II Via Sergio Pansini 5 Naples Italy I-80131
Citazione:
F. Piscione et al., "Low dose dobutamine echo cardiography for predicting functional recovery after coronary revascularisation", HEART, 86(6), 2001, pp. 679-686

Abstract

Objective-To evaluate the effects of chronic coronary occlusion on the accuracy of low dose dobutamine echo cardiography in predicting recovery of dysfunctional myocardium after revascularisation. Design-Retrospective study. Setting-Tertiary referral centre. Patients-53 consecutive patients with greater than or equal to 70% stenosis of the left anterior descending coronary artery (LAD) and regional ventricular dysfunction (group 1, non-occluded LAD; group 2, occluded LAD) who underwent dobutamine echocardiography. Interventions-26 patients underwent coronary artery bypass grafting and 27had percutaneous transluminal coronary angioplasty. Main outcome measures-Baseline studies before revascularisation included cross sectional echocardiography at rest and during dobutamine infusion (5-10 mug/kg min), and coronary angiography. The dobutamine study was performedmean (SD) 35 (28) days before revascularisation. Echo cardiography at restwas repeated 90 (48) days after revascularisation. Results-Of 296 dysfunctional segments, 63 in group 1 (43%; 63/146) and 69 in group 2 (46%; 69/150) (NS) improved at follow up. Mean (SD) regional wall motion score index decreased from 1.97 (0.48) (95% confidence interval (CI) 1.01 to 2.93) before revascularisation to 1.74 (0.52) (95% CI 0.70 to 2.78) at follow up in group 1 (p = 0.001), and from 2.12 (0.41) (95% CI 1.30 to 2.98) to 1.88 (0.36) (95% CI 1.16 to 2.60) in group 2 (p = 0.0006). In group 1, sensitivity (87% v 52%; p < 0.0001), negative predictive value (88%v 65%; p = 0.001), and accuracy (77% v 64%; p = 0.01) were all significantly higher than in group 2, despite the angiographic evidence of collateralsin patients with occluded vessels. Conclusions-Dobutamine echocardiography shows reduced sensitivity in predicting recovery of dysfunctional myocardium supplied by totally occluded vessels. Thus caution should be used in selecting such patients for revascularisation on the basis of a viability assessment made in this way.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/02/20 alle ore 14:58:12