RT Journal Article
SR Electronic
T1 Concordance between dobutamine Doppler tissue imaging echocardiography and rest reinjection thallium-201 tomography in dysfunctional hypoperfused myocardium
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 432
OP 437
DO 10.1136/hrt.82.4.432
VO 82
IS 4
A1 F Larrazet
A1 D Pellerin
A1 D Daou
A1 S Witchitz
A1 C Fournier
A1 A Prigent
A1 C Veyrat
YR 1999
UL http://heart.bmj.com/content/82/4/432.abstract
AB OBJECTIVE To evaluate the efficiency of the new technique colour Doppler tissue imaging (DTI) by studying the concordance between dobutamine DTI, standard grey scale echocardiography (SE), and rest-reinjection TI-201 tomography (TI) in dysfunctional myocardium.PATIENTS 23 patients with chronic wall motion abnormalities and proven coronary artery disease (> 70% diameter stenosis of at least one major coronary artery at angiogram).METHODS The contractile reserve and the resting perfusion characteristics of dysfunctional myocardial segments were assessed with low dose dobutamine SE and/or DTI (2.5 up to 20 γ/kg/min) and TI on a semiquantitative basis. The DTI or SE data were separately compared with TI, on the basis of a 13 segment ventricular model. The resulting score of combined DTI and SE was also compared with TI. Finally the results obtained from DTI were compared with SE.RESULTS A total of 142 severely hypokinetic or akinetic segments were visualised. The viability study was feasible in 127 (89%) and 121 (85%) segments with DTI and SE, respectively. TI detected viability more frequently than DTI (84 v 61, p < 0.001) and SE (80v 50, p < 0.001). However, as many viable segments were detected with combined DTI and SE as with TI (78v 84, NS). The κ values between TI and SE, DTI or combined SE and DTI were 0.38, 0.45, and 0.57, respectively, and increased to 0.52 and 0.76, respectively, for SE and DTI versus TI when mid-anterior and mid-inferior segments only were considered. The κ value between SE and DTI was 0.34.CONCLUSIONS DTI is a helpful adjunct to SE, when using low dose dobutamine. This combination revealed as many viable segments as TI and showed a better agreement than DTI or SE alone for the assessment of myocardial viable segments evidenced by TI.