DOES DOBUTAMINE STRESS ECHOCARDIOGRAPHY INDUCE DAMAGE DURING VIABILITY DIAGNOSIS OF PATIENTS WITH CHRONIC REGIONAL DYSFUNCTION AFTER MYOCARDIAL-INFARCTION

Experimental hibernating-model investigations of animals have shown th at myocardial necrosis can be induced by longer-term intracoronary dob utamine infusion. This study was designed to determine whether myocard ial infarction could be ascertained in patients with chronic regional wall motion abnormalities and greater than 75% stenosis in the supplyi ng coronary artery through dobutamine stress echocardiography. Twenty patients with coronary artery disease and regional resting wall motion abnormalities were examined with a standard dobutamine protocol (5 to 50 mu g/kg/min). Exclusion criteria were an acute coronary syndrome, severe heart failure, and severe hypertension. Creatine kinase (CK, CK MB), myoglobin, and troponine-I were measured before and at each of th e first 7 hours after beginning of infusion. Fourteen of these 20 pati ents exhibited viable myocardium. The serum markers CK, CKMB, myoglobi n, and troponin-I demonstrated no increase beyond the reference range, suggesting that with this protocol, no myocardial necrosis was induce d.