Resting ultrasonic tissue characterization and dobutamine stress echocardiography for prediction of functional recovery in chronic left ventricular ischemic dysfunction

This study was designed to assess the diagnostic accuracy of the percentage of resting systolic wall thickening (WT), dobutamine stress echocardiograp hy (DSE), resting cyclic variation of integrated backscatter (IBS-CV), and low-dose dobutamine stress IBS-CV (DSE-IB) for the prediction of regional f unction recovery (RFR) in patients with chronic left ventricular (LV) ische mic dysfunction. The study also evaluated whether or not global LV function affected the diagnostic accuracy. All studies were conducted before percut aneous transluminal coronary angioplasty (PTCA) and RFR was assessed after PTCA (mean interval, 10 months) in 30 patients with chronic LV ischemic dys function. Patients were divided into 2 groups according to the LV ejection fraction (LVEF): group A, LVEF<40%, n=14; group B, LVEF<greater than or equ al to>40%, n=16. Of a total of 480 segments, 37 initially demonstrating aki netic wall motion before PTCA were analyzed. The wall motion of 24 of the 3 7 segments improved on visual analysis after PTCA. In the prediction of RFR , resting WT, DSE, resting IBS-CV and DSE-IB had sensitivities of 79%, 79%, 92% and 62%, and specificities of 54%, 84%, 83% and 69%, respectively. In particular, the resting IBS-CV in group Al as well as DSE, was an excellent predictor of RFR (sensitivity, 100%; specificity, 86%; vs sensitivity, 82% ; specificity, 78%; respectively). Therefore, both resting IBS-CV and DSE a re useful predictors for RFR in patients with chronic LV ischemic dysfuncti on.