Prediction of functional recovery in patients with myocardial infarction after revascularization - Comparison of low-dose dobutamine stress echocardiography with fluorine-18 fluorodeoxyglucose positron emission tomography

The present study investigated the agreement between low-dose dobutamine st ress echocardiography (LDDSE) and fluorine-18 fluorodeoxyglucose positron e mission tomography (FDG-PET) and compared each technique's ability to detec t myocardial viability and predict functional recovery in 30 patients. AU p atients underwent revascularization, followed by echocardiography 5+/-3 mon ths. Of the 390 segments analyzed by echocardiography before revascularizat ion, 110 (28%) had abnormal wall motion. LDDSE showed viability in 66 sites of the 110 dyssynergic segments and 58 of these viable segments recovered their wall motion. With FDG-PET, 78 of the 110 dyssynergic segments were di agnosed as viable and 62 of these showed improvement of the wall motion. Th e sensitivities for LDDSE and FDG-PET to assess functional recovery were 84 % and 90%, respectively; specificities were 80% and 64%, respectively. Posi tive predictive values for LDDSE and FDG-PET were 88% and 79%; negative pre dictive values were 75% and 78%, respectively. Both methods had good sensit ivity for detecting improvement in regional function after revascularizatio n, but LDDSE had a higher specificity for detecting viability and a better positive predictive value for left Ventricular functional recovery.