Low dose dobutamine echocardiography is more predictive of reversible dysfunction after acute myocardial infarction than resting single photon emission computed tomographic thallium-201 scintigraphy

Am Heart J. 1997 Nov;134(5 Pt 1):822-34. doi: 10.1016/s0002-8703(97)80005-1.

Abstract

To directly compare dobutamine echocardiography and resting single photon emission computed tomographic (SPECT) thallium-201 (Tl-201) scintigraphy for the detection of reversible dysfunction, 64 patients underwent dobutomine echocardiography (baseline, low dose 5 and 10 mg/kg/min, and peak dose), rest Tl-201 scintigraphy (3 mCi - 15 minute and 3- to 4-hour SPECT imaging), and coronary angiography during the first week after acute myocardial infarction. Follow-up echocardiography was performed 4 to 8 weeks after discharge. Wall thickening improved at follow-up in 52% (207 of 399) of the dysfunctional segments. By receiver operating characteristic analysis, biphasic responses and sustained improvement during dobutamine echocardiography were more accurate (p < 0.01) than Tl-201 uptake by SPECT scintigraphy for reversible dysfunction. The greater accuracy of dobutamine echocardiography resulted from higher accuracy in akinetic segments, Q wave infarction, and multivessel coronary artery disease. In conclusion, dobutamine echocardiography was more accurate than resting SPECT Tl-201 scintigraphy for reversible dysfunction after acute myocardial infarction.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Cardiotonic Agents*
  • Coronary Angiography
  • Dobutamine*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnostic imaging*
  • Myocardial Infarction / drug therapy
  • Observer Variation
  • Predictive Value of Tests
  • ROC Curve
  • Thallium Radioisotopes*
  • Thrombolytic Therapy
  • Tomography, Emission-Computed, Single-Photon*
  • Ultrasonography

Substances

  • Adrenergic beta-Antagonists
  • Cardiotonic Agents
  • Thallium Radioisotopes
  • Dobutamine