Early low-dose dobutamine echocardiography predicts late functional recovery after thrombolyzed acute myocardial infarction

Background This study was undertaken to evaluate the ability of predischarg e low-dose dobutamine echocardiography to predict late left ventricular fun ctional recovery after thrombolyzed acute myocardial infarction. Methods and Results low-dose dobutaonine echocardiography was performed in 54 patients 4 +/- 2 days after acute myocardial infarction treated with thr ombolysis. Follow-up resting echocardiography was carried out in 49 of thes e patients at a mean of 18 +/- 6 months later. Viability was defined as rec overy of myocardial function at Follow-up, expressed as an improvement of w all motion of at least 1 grade or more in at least 2 contiguous infarct zon e segments. In 24 of the 49 patients (group I), wall motion at follow-vp im proved in comparison with the early resting echocardiographic study (1.72 /- 0.29 vs 1.37 +/- 0.34, P <.001). In the remaining 25 patients (group II) , no wall motion enhancement was seen at follow-vp (1.57 +/- 0.38 vs 1.58 /- 0.36, NS). In 22 of the 24 patients in group I, early low-dose dobutamin e echocardiography showed improvement in the wall motion score index compar ed with baseline resting measurements (1.72 +/- 0.29 vs 1.44 +/- 0.24, P <. 001). The positive and negative predictive value of early low-dose dobutami ne echocardiography to predict Functional recovery was 76% and 92%, respect ively. Conclusion Predischarge low-dose dobutamine echocardiography is an accurate tool for detecting viable myocardium and predicting late left ventricular recovery after acute myocardial infarction treated with thrombolysis.