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Dobutamine stress echocardiography is highly accurate for the prediction of contractile reserve in the early postoperative period, but may underestimate late recovery in contractile reserve after revascularization of the hibernating myocardium.

Author(s): Zaglavara T, Karvounis HI, Haaverstad R, Pillay TM, Hamilton JR, Hasan A, Parharidis GE, Louridas GE, Dark JH, Kenny A

Affiliation(s): Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, United Kingdom.

Publication date & source: 2006-03, J Am Soc Echocardiogr., 19(3):300-6.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

OBJECTIVE: We sought to investigate the accuracy of dobutamine stress echocardiography to predict the degree and timing of recovery in resting function and contractile reserve (CR) after revascularization of the hibernating myocardium. METHODS: In all, 24 patients with ischemic cardiomyopathy (ejection fraction < 40%) underwent dobutamine stress echocardiography 1 week before and 6 weeks, 3 months, and 6 months after coronary artery bypass grafting. RESULTS: Recovery rates at 6 weeks, 3 months, and 6 months postoperation were 21%, 33%, and 45% (P < .01) for resting function and 55%, 65%, and 74% (P < .01) for CR. Positive and negative predictive values for recovery of resting function and CR at 6 months postrevascularization were 66% vs 97% (P < .001) and 78% vs 48% (P < .001), respectively. Positive and negative predictive values were both high for recovery of CR at 6 weeks postrevascularization (89% and 78%). CONCLUSIONS: Dobutamine stress echocardiography can predict early recovery in CR postrevascularization with an excellent accuracy but may underestimate the degree of late recovery in CR.

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