Specificity and sensitivity of dobutamine induced ST-segment elevation andpseudonormalization of negative T-waves for detection of residual myocardial viability in patients with Q-wave myocardial infarction

Relation between ST-segment elevation or pseudonormalization of negative T- waves and local myocardial contractility was studied during low-dose 5 and 10 mg/kg/min dobutamine stress echocardiography in 37 patients (33 men and 4 women aged 58,7+/-1,5 years) with acute (n=26) or old (n=11) Q-wave myoca rdial infarction. Improvement of local contractility in the infarcted area during dobutamine infusion occurred in 26 patients (70%). New or further ST -segment elevation or pseudonormalization of negative T-waves developed mor e frequently in these patients. Sensitivity of ST-segment elevation and pse udonormalization of negative T-waves for detection of potentially reversibl e contractile dysfunction was 27 and 73% (p<0,01), specificity - 92% anal 7 3%, respectively. Thus pseudonormalization of negative T-waves or ST-segmen t elevation or both during low dose dobutamine infusion in patients with Q- wave myocardial infarction (acute or old) indicates the presence of viable myocardium in the area of infarction.