Early low-dose dobutamine echocardiography predicts late functional recovery after thrombolyzed acute myocardial infarction

Background This study was undertaken to evaluate the ability of predischarge low-dose dobutamine echocardiography to predict late left ventricular functional recovery after thrombolyzed acute myocardial infarction. Methods and Results Low-dose dobutamine echocardiography was performed in 54 patients 4 ± 2 days after acute myocardial infarction treated with thrombolysis. Follow-up resting echocardiography was carried out in 49 of these patients at a mean of 18 ± 6 months later. Viability was defined as recovery of myocardial function at follow-up, expressed as an improvement of wall motion of at least 1 grade or more in at least 2 contiguous infarct zone segments. In 24 of the 49 patients (group I), wall motion at follow-up improved in comparison with the early resting echocardiographic study (1.72 ± 0.29 vs 1.37 ± 0.34, P < .001). In the remaining 25 patients (group II), no wall motion enhancement was seen at follow-up (1.57 ± 0.38 vs 1.58 ± 0.36, NS). In 22 of the 24 patients in group I, early low-dose dobutamine echocardiography showed improvement in the wall motion score index compared with baseline resting measurements (1.72 ± 0.29 vs 1.44 ± 0.24, P < .001). The positive and negative predictive value of early low-dose dobutamine echocardiography to predict functional recovery was 76% and 92%, respectively. Conclusion Predischarge low-dose dobutamine echocardiography is an accurate tool for detecting viable myocardium and predicting late left ventricular recovery after acute myocardial infarction treated with thrombolysis. (Am Heart J 1999;137:489-93.)