Left ventricular remodeling can be predicted with left ventricular volume response during dobutamine echocardiography after acute myocardial infarction

Clin Cardiol. 2008 Jun;31(6):259-64. doi: 10.1002/clc.20207.

Abstract

Objectives: This study was performed to evaluate the significance of left ventricular (LV) volume response during dobutamine stress echocardiography (DSE) in the prediction of LV volume change during follow-up (F/U) in patients with acute myocardial infarction (AMI).

Methods: Forty-five patients with AMI (male 39, age 57+/-10 y, anterior myocardial infarction [MI] 29) underwent DSE 6+/-4 d after AMI. Revascularization of the infarct-related artery was performed if severe stenosis was present. A F/U echocardiography was performed 7.5+/-3.4 mo after DSE. The LV end-diastolic volume (EDV) and end-systolic volume (ESV) using the modified Simpson's method were measured at baseline echocardiography, low-dose (10 microg x kg(-1) x min(-1)) DSE, and F/U echocardiography.

Results: Patients were divided into 2 groups; Group I (n = 21) with an abnormal response (<10% decrease) in LVEDV during low-dose DSE; Group II (n = 24) with a normal response (> or =10% decrease) in LVEDV during low-dose DSE. At F/U echocardiography, the (%) change of LVEDV was significantly different between the 2 groups (-2.0+/-16.7 versus - 22.6+/-24.7%, p<0.01). Using multivariate analysis, the response of LVEDV (%) at low-dose DSE was the only significant independent predictor of the change of LVEDV (%) during F/U (y = 0.85 x - 0.03, r = 0.63, p<0.001).

Conclusions: The response of LVEDV during DSE can be used as a predictor for the LV volume change after AMI.

Publication types

  • Comparative Study

MeSH terms

  • Cardiac Volume / physiology*
  • Cardiotonic Agents*
  • Dobutamine*
  • Echocardiography, Stress / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Contraction / physiology
  • Myocardial Infarction / complications
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / physiopathology*
  • Predictive Value of Tests
  • Prognosis
  • Reproducibility of Results
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / physiopathology*
  • Ventricular Remodeling / physiology*

Substances

  • Cardiotonic Agents
  • Dobutamine