Accuracy of biphasic response, sustained improvement and worsening during dobutamine echocardiography in predicting recovery of resting myocardial dysfunction after revascularization: Comparison with thallium-201 SPECT

To evaluate the accuracy of various types of wall motion response during do butamine echocardiography (DE) in predicting functional recovery after reva scularization, we studied 30 patients with stable coronary disease and left ventricular dysfunction by simultaneous DE and Tl-201 reinjection SPECT. A mong 480 segments (16 segments/patient), 199 had abnormal wall motion at ba seline and 167 were revascularized. The predictive value for recovery of fu nction was 72% for a biphasic response, 61% for sustained improvement, 77% for worsening, and 27% for no change (p<0.01 vs. each). Biphasic response h ad a sensitivity of 40% and specificity of 85%. Combining biphasic, sustain ed improvement and worsening responses, the sensitivity, specificity and ac curacy were 76%, 65% and 71%, respectively. For Tl-201 SPECT, they were 90% , 65 % and 78%, respectively. Thus, a biphasic response alone is of low sen sitivity. Combination of biphasic, sustained improvement and worsening resp onses gives an accuracy rate comparable to that of Tl-201 reinjection SPECT in assessing functional recovery.