Can dobutamine stress echocardiography predict patient outcome after acute myocardial infarction?

Jeroen J Bax* and Don Poldermans

This article has no abstract so we have provided the first paragraph of the full text.

Over the past few years, it has become evident that improvement of left ventricular function is possible after surgical revascularization and can occur spontaneously after AMI.¹ In both settings, the recovery of left ventricular function has been related to the presence of dysfunctional but viable myocardium—hibernation in the setting of chronic ischemic left ventricular dysfunction, or stunning in the setting of AMI. At present, a variety of techniques are available for assessment of viability, which rely on identification of different features of viable myocardium including preserved perfusion, metabolism, contractile reserve and cell-membrane integrity. Perfusion and cell-membrane integrity can be assessed with single-photon emission CT using either thallium-201-labeled or technetium-99m-labeled agents; metabolism of glucose can be identified with PET using ¹⁸F-fluorodeoxyglucose, and contractile reserve can be visualized using echocardiography or MRI during low-dose dobutamine infusion.² Current investigations have used contrast-enhanced MRI extensively; however, this technique allows precise assessment of the amount of scar tissue rather than viable myocardium.²

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