Assessment of Residual Viability by Enoximone Echocardiography in Patients with Previous Myocardial Infarction Correlation with Positron Emission Tomographic Studies and Functional Follow-Up

Background: The aim of this study was to evaluate enoximone echocardiography (EE) for the identification of residual myocardial viability in postinfarction patients. Findings obtained during EE were compared with those acquired by myocardial uptake of fluorine‐18 fluorodeoxyglucose (18F‐FDG) positro...

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Published in:Echocardiography (Mount Kisco, N.Y.) N.Y.), 2010-05, Vol.27 (5), p.544-551
Main Authors: Lu, Fei, Carlino, Mauro, Lu, Chunzeng, Landoni, Claudio, Lucignani, Giovanni, Fragasso, Gabriele, Di Bello, Vitantonio, Margonato, Alberto, Chierchia, Sergio L., Marzilli, Mario, Balbarini, Alberto
Format: Article
Language:English
Subjects:
Aged
Coronary Angiography
echocardiography
Echocardiography - methods
Enoximone
Female
Fluorodeoxyglucose F18
Hemodynamics
Humans
Image Interpretation, Computer-Assisted
Male
Middle Aged
Myocardial Contraction
Myocardial Infarction - diagnostic imaging
Myocardial Infarction - physiopathology
Myocardial Revascularization
myocardial viability
Positron-Emission Tomography
Predictive Value of Tests
Radiopharmaceuticals
Vasodilator Agents
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container_start_page 544
container_title Echocardiography (Mount Kisco, N.Y.)
container_volume 27
creator Lu, Fei
Carlino, Mauro
Lu, Chunzeng
Landoni, Claudio
Lucignani, Giovanni
Fragasso, Gabriele
Di Bello, Vitantonio
Margonato, Alberto
Chierchia, Sergio L.
Marzilli, Mario
Balbarini, Alberto
description Background: The aim of this study was to evaluate enoximone echocardiography (EE) for the identification of residual myocardial viability in postinfarction patients. Findings obtained during EE were compared with those acquired by myocardial uptake of fluorine‐18 fluorodeoxyglucose (18F‐FDG) positron emission tomography (PET) and functional follow‐up results. Methods: Twenty‐five patients underwent EE and PET 18F‐FDG studies. An asynergic segment was considered as having contractile enhancement when the wall motion score decreased by ≥1 grade during EE and was defined as viable if 18F‐FDG uptake score was ≥2 grade on PET. Results: Of 293 dysfunctional segments at baseline, 139 (47%) were viable by PET criteria; 117 (40%) had contractile enhancement induced by enoximone (P = 0.07). Agreement between EE and PET was found in 75% of involved segments (K = 0.46, P < 0.001). The majority of discrepancies (65%, P < 0.01) were mainly due to discordant segments in which PET revealed evidence of 18F‐FDG uptake but EE showed no change in wall motion. In 179 revascularized segments, negative predictive value for functional recovery of both tests reached the same value (89% for both), whereas positive predictive value was 82% for EE and 68% for PET, respectively (P < 0.05). Sensitivity was 85% for EE and 88% for PET (P = ns); specificity was 87% and 70%, respectively (P < 0.01). Conclusions: EE yields a fair concordance with PET study. Compared with PET, despite a similar negative accuracy, EE shows a greater specificity for prediction of function recovery after revascularization. (Echocardiography 2010;27:544‐551)
doi_str_mv 10.1111/j.1540-8175.2009.01082.x
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Findings obtained during EE were compared with those acquired by myocardial uptake of fluorine‐18 fluorodeoxyglucose (18F‐FDG) positron emission tomography (PET) and functional follow‐up results. Methods: Twenty‐five patients underwent EE and PET 18F‐FDG studies. An asynergic segment was considered as having contractile enhancement when the wall motion score decreased by ≥1 grade during EE and was defined as viable if 18F‐FDG uptake score was ≥2 grade on PET. Results: Of 293 dysfunctional segments at baseline, 139 (47%) were viable by PET criteria; 117 (40%) had contractile enhancement induced by enoximone (P = 0.07). Agreement between EE and PET was found in 75% of involved segments (K = 0.46, P &lt; 0.001). The majority of discrepancies (65%, P &lt; 0.01) were mainly due to discordant segments in which PET revealed evidence of 18F‐FDG uptake but EE showed no change in wall motion. In 179 revascularized segments, negative predictive value for functional recovery of both tests reached the same value (89% for both), whereas positive predictive value was 82% for EE and 68% for PET, respectively (P &lt; 0.05). Sensitivity was 85% for EE and 88% for PET (P = ns); specificity was 87% and 70%, respectively (P &lt; 0.01). Conclusions: EE yields a fair concordance with PET study. Compared with PET, despite a similar negative accuracy, EE shows a greater specificity for prediction of function recovery after revascularization. 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Findings obtained during EE were compared with those acquired by myocardial uptake of fluorine‐18 fluorodeoxyglucose (18F‐FDG) positron emission tomography (PET) and functional follow‐up results. Methods: Twenty‐five patients underwent EE and PET 18F‐FDG studies. An asynergic segment was considered as having contractile enhancement when the wall motion score decreased by ≥1 grade during EE and was defined as viable if 18F‐FDG uptake score was ≥2 grade on PET. Results: Of 293 dysfunctional segments at baseline, 139 (47%) were viable by PET criteria; 117 (40%) had contractile enhancement induced by enoximone (P = 0.07). Agreement between EE and PET was found in 75% of involved segments (K = 0.46, P &lt; 0.001). The majority of discrepancies (65%, P &lt; 0.01) were mainly due to discordant segments in which PET revealed evidence of 18F‐FDG uptake but EE showed no change in wall motion. In 179 revascularized segments, negative predictive value for functional recovery of both tests reached the same value (89% for both), whereas positive predictive value was 82% for EE and 68% for PET, respectively (P &lt; 0.05). Sensitivity was 85% for EE and 88% for PET (P = ns); specificity was 87% and 70%, respectively (P &lt; 0.01). Conclusions: EE yields a fair concordance with PET study. Compared with PET, despite a similar negative accuracy, EE shows a greater specificity for prediction of function recovery after revascularization. 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Findings obtained during EE were compared with those acquired by myocardial uptake of fluorine‐18 fluorodeoxyglucose (18F‐FDG) positron emission tomography (PET) and functional follow‐up results. Methods: Twenty‐five patients underwent EE and PET 18F‐FDG studies. An asynergic segment was considered as having contractile enhancement when the wall motion score decreased by ≥1 grade during EE and was defined as viable if 18F‐FDG uptake score was ≥2 grade on PET. Results: Of 293 dysfunctional segments at baseline, 139 (47%) were viable by PET criteria; 117 (40%) had contractile enhancement induced by enoximone (P = 0.07). Agreement between EE and PET was found in 75% of involved segments (K = 0.46, P &lt; 0.001). The majority of discrepancies (65%, P &lt; 0.01) were mainly due to discordant segments in which PET revealed evidence of 18F‐FDG uptake but EE showed no change in wall motion. In 179 revascularized segments, negative predictive value for functional recovery of both tests reached the same value (89% for both), whereas positive predictive value was 82% for EE and 68% for PET, respectively (P &lt; 0.05). Sensitivity was 85% for EE and 88% for PET (P = ns); specificity was 87% and 70%, respectively (P &lt; 0.01). Conclusions: EE yields a fair concordance with PET study. Compared with PET, despite a similar negative accuracy, EE shows a greater specificity for prediction of function recovery after revascularization. (Echocardiography 2010;27:544‐551)</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>20374267</pmid><doi>10.1111/j.1540-8175.2009.01082.x</doi><tpages>8</tpages></addata></record>
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source Wiley-Blackwell Journals
subjects Aged
Coronary Angiography
echocardiography
Echocardiography - methods
Enoximone
Female
Fluorodeoxyglucose F18
Hemodynamics
Humans
Image Interpretation, Computer-Assisted
Male
Middle Aged
Myocardial Contraction
Myocardial Infarction - diagnostic imaging
Myocardial Infarction - physiopathology
Myocardial Revascularization
myocardial viability
Positron-Emission Tomography
Predictive Value of Tests
Radiopharmaceuticals
Vasodilator Agents
title Assessment of Residual Viability by Enoximone Echocardiography in Patients with Previous Myocardial Infarction Correlation with Positron Emission Tomographic Studies and Functional Follow-Up
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