Abstract
Contractile reserve, during low-dose dobutamine echocardiography, is frequently used for the assessment of myocardial viability in patients with coronary artery disease (CAD) and left ventricular (LV) dysfunction. Whether contractile reserve is affected by the severity of the underlying CAD is presently unknown. Accordingly, we studied 58 patients with stable CAD and LV dysfunction who underwent coronary angiography and low-dose dobutamine echocardiography. In each vascular region the worst stenosis was identified and quantitated as percent diameter stenosis. Segmental wall motion during echocardiography was scored visually and rest and dobutamine wall motion score indexes were calculated. Contractile reserve was defined as > or = 1 grade improvement in wall motion score of > or = 2 contiguous segments along with > or = 20% reduction in global wall motion score index with dobutamine. There was no difference between patients with (n = 26) and without (n = 32) contractile reserve in percent coronary stenosis (89 +/- 17% vs 87 +/- 17%, p = 0.6), number of coronary arteries with > 50% diameter stenosis (2.0 +/- 0.8 vs 2.2 +/- 0.7, p = 0.4), number of occluded coronary arteries (1.2 +/- 0.9 vs 1.1 +/- 0.9, p = 0.6), or the prevalenc...Continue Reading
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