Detection of viable myocardium: comparison of dobutamine echocardiography and echocardiography after hyperbaric oxygenation

Veselka J, Mates M, V. Dolezal. Detection of viable myocardium: comparison of dobutamine echocardiography and echocardiography after hyperbaric oxygen ation. Undersea Hyper Med 1999; 26(1):9-13.-The study concerned the possibi lity of using echocardiography after hyperbaric oxygenation (HBO2) to detec t viable myocardium. Results were compared with dobutamine stress echocardi ography (DSE). Seventeen patients with left ventricular dysfunction were en rolled in this study. The regional wall motion of the left ventricle was as sessed for every patient and a wall motion score index was calculated. A re sting wall motion abnormality was found in 204 segments (75%), of which 119 segments (58%) improved during DSE, and 59 (29%) after HBO2. Of 119 segmen ts with evidence of viability in DSE, HBO2 showed viability in 58 segments. Of 85 segments non-viable in DSE, 84 segments were also non-viable after H BO2. The positive and negative predictive values of HBO2 compared to DSE we re 98 and 58%, respectively. Comparing the wall motion score index at rest with the index after DSE 5 and 10 mu g.kg(-1) . min(-1) dobutamine and afte r HBO2, there was significant improvement (P < 0.005). Differences between DSE 5 mu g . kg(-1) . min(-1) dobutamine and DSE mu g . kg(-1) . min(-1) do butamine and between HBO2 and DSE 10 mu g . kg(-1) min(-1) dobutamine were also significant (P < 0.005). There was no significant difference between D SE 5 mu g kg(-1) . min(-1) and HBO2. Echocardiography after HBO2 is a new m ethod for the detection of viable myocardium. It appears similar in accurac y to DSE 5 mu g . kg(-1) . min(-1), but is inferior to DSE 10 mu g . kg(-1) . min(-1).