Myocardial viability assessed by dobutamine echocardiography in acute myocardial infarction after successful primary coronary angioplasty

Am J Cardiol. 1997 Jul 1;80(1):6-10. doi: 10.1016/s0002-9149(97)00275-0.


Dobutamine echocardiography (5 and 10 microg/kg/ min) was performed in 40 patients 4 +/- 1 days after acute myocardial infarction reperfused by primary coronary angioplasty. The left ventricle was divided into 11 segments. Reversible myocardial dysfunction was indicated by a decrease in at least 2 grades in the total segmental score. Follow-up echocardiography was performed 2 months later. Contractile reserve was documented in 18 patients with dobutamine echocardiography (45%). Sensitivity, specificity, positive, and negative predictive value of dobutamine echocardiography in predicting improvement in contractile function at follow-up were 82%, 83%, 78%, and 86%, respectively. Negative predictive value was high in all dyssynergic segments (86%). Positive predictive value was higher in hypokinetic than in akinetic segments (73% vs 21%; p <0.05). Recovery of wall motion at follow-up was statistically associated with higher left ventricular ejection fraction (p <0.04), collateral blood flow before reperfusion (p = 0.007), and dobutamine responsiveness (p = 0.0001), and was more frequently observed in hypokinetic than in akinetic segments (p <0.05). Thus, low-dose dobutamine echocardiography accurately predicts the extent of irreversibly damaged myocardium early after successful direct coronary angioplasty in acute myocardial infarction.

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary
  • Cardiac Catheterization
  • Coronary Angiography
  • Dobutamine*
  • Echocardiography / methods*
  • Exercise Test
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Contraction
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / therapy*
  • Predictive Value of Tests
  • Sensitivity and Specificity


  • Dobutamine