Je akustická denzitometrie v diagnostice viability myokardu lepší než dobutaminová echokardiografie ?
Title in English | Is acoustic densitometry better than dobutamine echocardiography in a viability assessment |
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Authors | |
Year of publication | 2004 |
Type | Article in Periodical |
Magazine / Source | Kardiológia - Cardiology |
MU Faculty or unit | |
Citation | |
Field | Cardiovascular diseases incl. cardiosurgery |
Keywords | acoustic densitometry; viability; coronary artery disease |
Description | Aim: The purpose of this study has been to compare acoustic densitometry and dobutamine echocardiography for an assessment of myocardial viability. Methods: Fifty-four patients with coronary artery disease and dysfunctional myocardial segments, who were referred for myocardial revascularization, underwent a viability assessment using acoustic densitometry. Thirty-four patients underwent also low-dose dobutamine echocardiography. Amplitude of cyclic variation of integrated backscatter (CVIB) was evaluated from each dysfunctional segment. The receiver operating characteristics curve analysis was applied to determine the optimal cut off value of CVIB for distinction between viable and nonviable dysfunctional myocardium. Results of the two techniques were compared to follow-up resting echocardiography, which was performed at a mean of 3 months after successful revascularization in order to assess the recovery of function in revascularized, initially dysfunctional segments. Echocardiography was performed in standard views using 16-segment model of the left ventricle. Viable myocardium was identified by the augmentation of systolic thickening of an abnormal segment by at least one grade during dobutamine infusion or by the value of the maximal amplitude of cyclic variation of integrated backscatter (CVIB). Results: Acoustic densitometry had the sensitivity and specificity to predict functional recovery 90% and 77%, respectively. Dobutamine echocardiography had the sensitivity and specificity to predict contractile reserve 83% and 81%, respectively. The results were statistically comparable. Concordance between these methods was 80%. Conclusion: Acoustic densitometry and dobutamine echocardiography have comparable sensitivities and specificities for the prediction of functional recovery after coronary revascularization. |
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