Heart, Lung and Circulation
Volume 19, Issue 2 , Pages 81-89, February 2010

The Combined Pharmacological Stress Echocardiography Protocol for Predicting Improvement of Global Left Ventricular Systolic Function After Revascularisation

  • Zainab Abdel-Salam, MD
    • ,
  • Wail Nammas, MD

      Affiliations

    • Corresponding Author InformationCorresponding author at: Cardiology Department, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Abbassia, P.O. 11381, Cairo, Egypt. Tel.: +20 2 248 20 415; fax: +20 2 248 20 416.

Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Received 7 February 2009; received in revised form 20 June 2009; accepted 17 August 2009.

Background

We compared the prognostic power of three pharmacological stress echocardiography protocols for predicting improvement of global left ventricular systolic function following revascularisation.

Methods

We enrolled 100 consecutive patients with significant coronary stenosis/occlusion and regional dys-synergy in the affected artery territory. Patients underwent assessment of regional and global left ventricular systolic function. They underwent then three pharmacological stress echocardiography protocols: low dose dobutamine, infra-low dose dipyridamole, combined protocol. All patients underwent coronary revascularisation. Echocardiography was repeated 8 weeks later. Predicted function improvement by the three protocols was compared with actual improvement.

Results

The combined protocol was more sensitive to predict systolic function improvement after revascularisation, but less specific, the diagnostic accuracy was similar among the three protocols. A cutoff value of 6 viable segments best predicted global function improvement with the combined protocol.

Conclusions

The combined protocol has a higher sensitivity but lower specificity to predict global left ventricular systolic function improvement after revascularisation, as compared to the other two protocols.

Keywords: Stress echocardiography, Viability, Myocardial infarction

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PII: S1443-9506(09)01055-5

doi:10.1016/j.hlc.2009.08.008

Heart, Lung and Circulation
Volume 19, Issue 2 , Pages 81-89, February 2010

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