科研之友
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摘要
Objective We explored the accuracy of resting echocardiographic and tissue Doppler parameters to predict a positive response by low-dose dobutamine stress echocardiography (DSE) in patients with ischaemic cardiomyopathy. %26lt;br%26gt;Methods and results We enrolled 100 consecutive patients with prior myocardial infarction, and a left ventricular ejection fraction (LVEF) %26lt; 35%. They underwent resting echocardiographic assessment of LVEF, wall motion score index (WMSI), mitral E and A peak velocities, E/A ratio, E peak deceleration time, isovolumetric relaxation time (IVRT), early mitral annular diastolic velocity (e%26apos;), and E/e%26apos; ratio. Subsequently, they underwent low-dose DSE for assessment of myocardial viability. The presence of viability was defined by improvement of the regional wall motion score by %26gt;= 1 grade in %26gt;= 5 myocardial segments, with %26gt;= 20% reduction in WMSI compared with baseline evaluation. Thirty-six patients had a negative response to DSE (group I); 64 had a positive response (group II). Resting LVEF was higher, and resting WMSI lower in group II versus group I; E peak deceleration time and IVRT shorter in group I (P %26lt; 0.05 for all). Multivariable regression analysis identified LVEF, WMSI, and IVRT as the independent predictors of a positive response to DSE. A cutoff value of LVEF of %26gt; 25% predicted viability with a sensitivity of 85.9%, specificity 80.6%; WMSI of %26lt;= 2.6 had a sensitivity of 85.7%, specificity 61.1%; IVRT of %26gt; 60 msec had a sensitivity of 93.7%, specificity 47.2%. %26lt;br%26gt;Conclusions Resting LVEF %26gt; 25%, WMSI %26lt;= 2.6, and IVRT %26gt; 60 msec predicted viability with a high sensitivity; however, with the exception of LVEF, specificity was quite low.
- 出版日期2012-12
