Literature DB >> 8436738

Ischemia-induced regional wall motion abnormality is improved after coronary angioplasty: demonstration by dobutamine stress echocardiography.

K O Akosah1, T R Porter, R Simon, J T Funai, A J Minisi, P K Mohanty.   

Abstract

OBJECTIVES: The purpose of this study was to examine whether dobutamine stress echocardiography can detect reversal of ischemia-induced left ventricular regional wall motion abnormality immediately after percutaneous transluminal coronary angioplasty.
BACKGROUND: Although angioplasty is routinely performed as a means of coronary revascularization, at present there is a question whether this results in an immediate improvement in ischemia-induced left ventricular regional function.
METHODS: Thirty-five patients underwent dobutamine stress echocardiography 24 h before and 24 to 48 h after angiographically successful coronary angioplasty. Only patients with normal wall motion at rest were included. Dobutamine infusion was begun at 5 micrograms/kg per min and increased at 5-min intervals (10, 20, 30, 40 micrograms/kg per min). Echocardiographic images were stored into cine loops and analyzed off line with simultaneous comparison of images acquired at baseline, 5 micrograms/kg per min, peak infusion and recovery. Echocardiographic images were interpreted independently, without knowledge of other data, by two experienced cardiologists using the 16-myocardial segment model.
RESULTS: Before angioplasty, dobutamine stress echocardiography induced wall motion abnormalities in 31 patients (88%). Wall motion score at peak dobutamine infusion improved in 28 (90%) of the 31 patients after angioplasty. Wall motion score at peak dobutamine infusion for the group improved from 20 +/- 3 before angioplasty to 17 +/- 2 after angioplasty (p < 0.001). There was no change in the rate-pressure product achieved for the group before and after angioplasty (20,038 +/- 6,415 beats/min x mm Hg before versus 20,775 +/- 5,435 after angioplasty, p = NS). Before angioplasty, dobutamine stress echocardiography induced angina in 13 patients (37%), whereas angina occurred only once after angioplasty. Electrocardiographic changes diagnostic of ischemia occurred seven times, all before angioplasty.
CONCLUSIONS: We conclude that dobutamine stress echocardiography is an excellent method to demonstrate an immediate improvement in stress-induced regional left ventricular dysfunction in the distribution of the vessel undergoing successful angioplasty.

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Year:  1993        PMID: 8436738     DOI: 10.1016/0735-1097(93)90088-i

Source DB:  PubMed          Journal:  J Am Coll Cardiol        ISSN: 0735-1097            Impact factor:   24.094


  2 in total

1.  Serial assessment of left ventricular function during dobutamine stress by means of electrocardiography-gated myocardial SPECT: combination with dual-isotope myocardial perfusion SPECT for detection of ischemic heart disease.

Authors:  S Kumita ; K Cho; H Nakajo; M Toba; T Kijima; S Mizumura; T Oshina; T Kumazaki; J Sano; K Sakurai; K Munakata
Journal:  J Nucl Cardiol       Date:  2001 Mar-Apr       Impact factor: 5.952

2.  Dobutamine Stress Echocardiography Ischemia as a Predictor of the Placebo-Controlled Efficacy of Percutaneous Coronary Intervention in Stable Coronary Artery Disease: The Stress Echocardiography-Stratified Analysis of ORBITA.

Authors:  Rasha K Al-Lamee; Matthew J Shun-Shin; James P Howard; Alexandra N Nowbar; Christopher Rajkumar; David Thompson; Sayan Sen; Sukhjinder Nijjer; Ricardo Petraco; John Davies; Thomas Keeble; Kare Tang; Iqbal Malik; Nina Bual; Christopher Cook; Yousif Ahmad; Henry Seligman; Andrew S P Sharp; Robert Gerber; Suneel Talwar; Ravi Assomull; Graham Cole; Niall G Keenan; Gajen Kanaganayagam; Joban Sehmi; Roland Wensel; Frank E Harrell; Jamil Mayet; Simon Thom; Justin E Davies; Darrel P Francis
Journal:  Circulation       Date:  2019-11-11       Impact factor: 29.690

  2 in total

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