STUDY OF MYOCARDIAL VIABILITY AFTER RECEN T MYOCARDIAL-INFARCTION BY DOBUTAMINE STRESS ECHOCARDIOGRAPHY - IDENTIFICATION OF STUNNED MYOCARDIUM

After myocardial infarction treated by thrombolysis, secondary improve ment of contractility may be observed due to the presence of viable bu t stunned myocardium in a zone of ischaemia. Echocardiography with low dose Dobutamine has been proposed as a diagnostic test of myocardial viability. The inotropic effect of the pharmacological agent improves or induces myocardial thickening in zones of ischaemia. A positive res ponse is observed in about one out of two cases. The sensitivity range s from 79 to 86 % and the specificity from 68 to 90 % in the reported series. This mode of stress echocardiography for the study of post-inf arction myocardial viability is under clinical evaluation : its advant ages and Limitations should be compared with those of other non-invasi ve methods, especially thallium myocardial scintigraphy.