Regular paperIn-hospital and long-term prognostic value of viable myocardium detected by dobutamine echocardiography early after acute myocardial infarction and its relation to indicators of left ventricular systolic dysfunction
Section snippets
Patient population
The study population consisted of 138 consecutive patients (<76 years old) with AMI admitted to the Coronary Care Unit of the Free University Hospital and the Sint Lucas-Andreas Hospital. Myocardial infarction was documented by a history of typical chest pain, ST-segment elevation in 2 contiguous leads and a transient increase in creatine kinase more than twice the upper limit of normal. Patients treated with and without thrombolytic therapy or primary coronary angioplasty, with first or
Patient characteristics
On the basis of the results of the dobutamine study, patients were divided into 2 groups: 55 patients with viability and 83 patients without viability. Baseline characteristics of both groups are shown in Table 1.
In-hospital events
No complications occurred during low-dose dobutamine echocardiography. Patients were hospitalized for 13 ± 7 days (range 4 to 49). The hospital stay for uncomplicated AMI was 11 ± 5 days. After elimination of patients who had bypass surgery or coronary angioplasty, which might
Discussion
To date, several retrospective studies have evaluated the prognostic implications of myocardial viability, detected by positron emission tomography or dobutamine stress echocardiography, in patients with chronic coronary artery disease and moderate to severe LV dysfunction.13, 14, 15, 16 In general, these studies have shown that presence of viable myocardium, if left unrevascularized, leads to a greater number of events14, 16 and cardiac death.13, 14, 15 The prognostic benefit of
Acknowledgements
We appreciate the great support from our technicians Irma Bekkering, Sylvia Bruinzeel, Anja Folkers and Beatrix Willemsen.
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