Prediction of improvement of ventricular function after revascularization. 18F-fluorodeoxyglucose single-photon emission computed tomography vs low-dose dobutamine echocardiography

European Heart Journal
J H CornelJ R Roelandt

Abstract

To compare assessment of myocardial flow and glucose metabolism by single-photon emission computed tomography (SPECT) with low-dose dobutamine echocardiography in predicting improvement in regional and global left ventricular function after coronary artery bypass grafting. Thirty patients with regional wall motion abnormalities (mean ejection fraction 32 +/- 19%) were studied with low-dose dobutamine echocardiography (5 and 10 micrograms. kg-1 min-1) and thallium-201/ 18F-fluorodeoxyglucose(FDG) SPECT prior to surgery. For comparative analysis, a 13-segment model was used. Postoperative improvement was predicted if the echocardiogram showed that wall motion abnormalities were reversible during the dobutamine infusion and there was normal perfusion or relatively increased FDG uptake in perfusion defects (mismatch) in dyssynergic segments on SPECT. After surgery, ventricular function was reassessed. An echocardiogram was taken at the 3 month follow-up with the patient at rest. Regional wall motion had improved in 62/168 (37%) revascularized segments. In predicting functional outcome, low-dose dobutamine echocardiography reached a sensitivity of 89% and a specificity of 82%, with a positive predictive value of 74% and a negative p...Continue Reading

Citations

Feb 15, 2002·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Vuy Hun LiJonathan S Steinberg
May 21, 1998·Herz·M Elsner

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