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Rivista sulle Malattie del Cuore e dei Vasi
Official Journal of the Italian Society of Angiology and Vascular Pathology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Cardioangiologica 2015 Dicembre;63(6):483-93
The percent change of strain and strain rate under dobutamine stress echocardiography predicts viability following myocardial infarction
Ismail M., Khalid S., Eldemerdash S., Elmallal W., Bahy H., Nammas W. ✉
El Demerdash Hospital, Cardiology Department, Faculty of medicine Ain Shams University, Cairo, Egypt
AIM: The aim of the present study was to explore the accuracy of the dobutamine-induced percent change of myocardial deformation indices to detect viability following myocardial infarction.
METHODS: We enrolled 60 consecutive patients presenting for myocardial viability assessment at least 4 weeks following ST-segment-elevation myocardial infarction. Strain (S) and strain rate (SR) were individually measured for all myocardial segments, both at rest and during low-dose dobutamine stress echocardiography. The percent change of S and SR from baseline to dobutamine-induced values (at a dose of 20 µg/kg/min) was calculated individually for each segment. Patients underwent myocardial viability assessment with resting 99mTc-sestamibi scintigraphy. Based on the results of scintigraphy, the percent change of S and SR was compared between viable and non-viable segments.
RESULTS: For all segments, the percent change of both S and SR was significantly higher in viable as compared with non-viable segments (P<0.05 for all). Receiver-operating characteristics curve analysis identified the optimal cut-off value for the percent change of both S and SR that best discriminates viable from non-viable segments in the range of 20-25% with a sensitivity range from 95% to 100%, and a specificity range from 85% to 100%.
CONCLUSION: In patients undergoing viability assessment following ST segment elevation myocardial infarction, the percent change of both S and SR (from baseline to dobutamine-induced values) was significantly higher in viable versus non-viable segments. A cut-off value of 20-25% of the percent change for both S and SR reliably identified viable from non-viable segments with a high sensitivity and specificity for both.