Enoximone echocardiography for predicting recovery of left ventricular dysfunction after revascularization - A novel test for detecting myocardial viability

Article; Proceedings Paper

关键词: CORONARY-ARTERY DISEASE;    DOBUTAMINE STRESS ECHOCARDIOGRAPHY;    CONGESTIVE HEART-FAILURE;    POSITRON-EMISSION TOMOGRAPHY;    WALL-MOTION ABNORMALITIES;    LOW-DOSE DOBUTAMINE;    CONTRACTILE RESPONSE;    VIABLE MYOCARDIUM;    CARDIOTONIC AGENT;    MDL-17,043;   

DOI  :  10.1161/01.CIR.101.11.1255

来源: SCIE

【 摘 要 】

Background-The possibility that enoximone, a nonglycoside, noncatechol, positive inotropic agent, in combination with 2-dimensional echocardiography may predict recovery of myocardial dysfunction after revascularization has not been yet evaluated. Methods and Results-Forty-five patients with chronic coronary artery disease and left ventricular dysfunction underwent dobutamine (DE, 5 to 10 mu g . kg(-1) . min(-1)) and enoximone (EE, 1.5 mg/kg, over 10 minutes) echocardiography. Myocardial wall motion was scored from 1 (normal) to 4 (dyskinesia): an asynergic segment was considered to have contractile enhancement when the score decreased by greater than or equal to 1 grade. Of 478 asynergic segments, 216 (45%) exhibited functional recovery after revascularization. Dobutamine- and enoximone-induced contractile enhancement was observed in 41% and 46% of segments, respectively, Compared with DE, EE had higher sensitivity (88% versus 79%, P<0.01) and negative predictive value (90% versus 84%, P<0.05) in predicting functional recovery. The specificity (89% versus 90%) and positive predictive value (87% for both EE and DE) were similar. Concordant interpretation of EE and DE findings was found in 85% (406 of 478) of affected segments. Prerevascularization coronary angiography showed that stenosis severity of vessels supplying areas which only improved with enoximone was significantly greater (89.9%) than that of vessels (77.7%) supplying areas that responded to both agents (P<0.02), Both dobutamine and enoximone increased heart rate (16% and 10%, respectively), whereas enoximone did not cause changes in systolic blood pressure that increased by 14% with dobutamine. Conclusions-Enoximone echocardiography provides a novel and reliable approach for the prediction of functional recovery after revascularization. Compared with dobutamine echocardiography, the test yields higher sensitivity and induces lesser hemodynamic alterations.

【 授权许可】

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