DIAGNOSTIC AND PROGNOSTIC VALUE OF DIPYRIDAMOLE AND DOBUTAMINE STRESSECHOCARDIOGRAPHY IN PATIENTS WITH Q-WAVE ACUTE MYOCARDIAL-INFARCTION

The aim of this study was to compare dipyridamole and dobutamine stres s echocardiography, performed early in patients with acute myocardial infarction (AMI) to evaluate residual ischemia, viability, and prognos is. Fifty patients (mean age 55 +/- 9 years, 47 men, 3 women) with AMI , all treated with thrombolytic therapy, underwent standard dipyridamo le and dobutamine tests, within the fifth day of the event. Wall motio n score index and the 16 segments model were used to evaluate contract ility. Forty-seven patients underwent coronary angiography within the tenth day of the event. The mean follow-vp was 24 +/- 12 months. No si de effects occurred during both tests. Both dipyridamole and dobutamin e tests were positive for ischemia, in 32 and 33 of 47 patients, respe ctively (sensitivity 73% and 75%; specificity 67% and 67%); these test s induced an improvement of contractility in 23 and 38 of 139 abnormal segments at baseline, respectively (sensitivity 52% and 86%; specific ity 100% and 100%). Cardiac events occurred in 26 of 50 patients, 22 w ith a positive dipyridamole test and 21 with positive dobutamine test. Thus, both tests were feasible, safe, and useful to evaluate residual ischemia, viability, and prognosis. No significant differences were f ound in sensitivity and specificity between tests. (C) 1997 by Excerpt a Medico, Inc.