Dobutamine stress-echocardiography in diagnosis of myocardial viability after myocardial revascularization

Aim. To determine sensitivity and specificity of low dose dobutamine stress -echocardiography for diagnosis of viable myocardium. Material and methods. Stress-echocardiography was carried out in 26 patients with myocardial inf arction and disturbances of regional myocardial contractility (wall motion score index 1,12 - 2,12, mean 1,47+/-0,07) before and after myocardial reva scularization (angioplasty of symptom related artery in 12 and coronary art ery bypass surgery in 14 patients). Results. Significant improvement of reg ional contractility occurred both after angioplasty (average wall motion sc ore index 1,24+/-0,09) and bypass surgery (average wall motion score index 1,15+/-0,05). Improvement was observed in 113 (76%) of 149 segments with in itially disturbed contractility. Viable myocardium in the zone of coronary artery occlusion was found with the same frequency as in the zone supplied by stenosed artery. Conclusion. Low dose stress echocardiography allowed to reveal viable myocardium prior to revascularization with sensitivity 65% a nd specificity 92%. Stress echocardiography was less sensitive in patients with pronounced disturbances of local contractility (akinesia and dyskinesi a).