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Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice
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[Pharmacological stress echocardiography for diagnosing of viable myocardium in severe left ventricular dysfunction]

Wei-xian Yang1, Yue-jin Yang, Feng-huan Hu

  • 1Division of Coronary Heart Disease, Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China. ywx66@yahoo.com.cn

Zhonghua Nei Ke Za Zhi
|October 1, 2005
PubMed

Insights

Combining dobutamine with isosorbide dinitrate in stress echocardiography improves the prediction of regional movement recovery after coronary revascularization in patients with old myocardial infarction and severe left ventricular dysfunction, without inducing ischemia.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Pharmacology

Background:

  • Old myocardial infarction (OMI) with severe left ventricular dysfunction presents challenges in predicting recovery after coronary revascularization (CRV).
  • Stress echocardiography is a key tool for assessing myocardial viability and predicting post-revascularization outcomes.

Purpose of the Study:

  • To compare the safety, sensitivity, specificity, and accuracy of low-dose dobutamine (Dob), isosorbide dinitrate, and their combination in stress echocardiography.
  • To predict regional myocardial movement recovery after CRV in patients with OMI and severe left ventricular dysfunction.

Main Methods:

  • Forty patients with OMI awaiting CRV underwent stress echocardiography using dobutamine (3, 5, 10 microg/kg/min), isosorbide dinitrate (270 microg/min), or their combination.
  • Twenty-six patients completed follow-up echocardiography 6.8 months post-CRV.

Main Results:

  • Dobutamine alone increased side effects and induced ischemia at higher doses (10 microg/kg/min).
  • The combination of dobutamine and nitrate showed no ischemia and improved sensitivity and accuracy compared to either agent alone.
  • Isosorbide dinitrate plus dobutamine 5 microg/kg/min demonstrated comparable efficacy to dobutamine 10 microg/kg/min alone.

Conclusions:

  • Dobutamine stress echocardiography (5-10 microg/kg/min) is effective but carries risks of ischemia.
  • Combining nitrate with dobutamine enhances diagnostic performance and safety for predicting myocardial viability post-CRV.
  • The combination of isosorbide dinitrate and dobutamine (5 microg/kg/min) offers a safe and effective alternative for assessing myocardial viability.
Abstract

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