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Diagnostic accuracy of low-dose dobutamine echocardiography in predicting post-revascularisation recovery of function in patients with chronic coronary artery disease: Relationship to thallium-201 uptake (91 visite)

Pace L, Filardi PP, Cuocolo A, Prastaro M, Acampa W, Dellegrottaglie S, Storto G, Della Morte AM, Piscione F, Chiariello M, Salvatore M

Eur J Nucl Med (ISSN: 0340-6997, 1619-7070, 1619-7089), 2001 Nov; 28(11): 1616-1623.

Tipo di articolo: Journal Article,

Impact factor: 3.464

Impact factor a 5 anni: 4.728


Parole chiave: Chronic Coronary Artery Disease, Low-Dose Dobutamine Echocardiography, Thallium-201, Thallium 201, Accuracy, Adult, Aged, Akinesia, Article, Clinical Trial, Controlled Clinical Trial, Controlled Study, Convalescence, Disease Severity, Drug Infusion, Drug Uptake, Female, Follow Up, Heart Muscle Contractility, Heart Muscle Revascularization, Heart Scintiscanning, Human, Image Analysis, Major Clinical Study, Prediction, Sensitivity And Specificity, Single Photon Emission Computer Tomography, Two Dimensional Echocardiography, Coronary Disease, Stress, Middle Aged, Myocardial Contraction, Myocardial Revascularization, Predictive Value Of Tests, Recovery Of Function, Thallium Radioisotopes, Emission-Computed, Single-Photon,

Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-0034767626&partnerID=40&md5=fa766a1e68de8a7af6c20be677c8e6ee

It is known that contractile reserve may be blunted if perfusion and coronary flow reserve are reduced. Thus, it is conceivable that the predictive accuracy of dobutamine echocardiography may differ according to perfusion tracer uptake. The aim of this study was therefore to assess the relationship between the level of thallium-201 uptake and the accuracy of dobutamine echocardiography in identifying reversible dysfunction. Sixty-nine patients (age 59±8 years, ejection fraction 40%±11%) with chronic coronary artery disease scheduled for coronary revascularisation were studied. All patients underwent rest 201Tl single-photon emission tomography and two-dimensional echocardiography at rest and during low-dose dobutamine infusion on the same day before revascularisation and repeated echocardiography at least 30 days thereafter. At follow-up, recovery of function was observed in 49% of 339 dysfunctional segments. The percentage of segments with post-revascularisation recovery of function and the percentage with contractile reserve increased in parallel with 201Tl uptake both in the total group of segments (χ2=35.5, P<0.0001 and χ2=35.9, P<0.0001, respectively) and among the 183 akinetic segments (χ2=44.4, P<0.0001 and χ2=14.6, P<0.05, respectively). The dysfunctional segments were divided into three groups according to 201Tl uptake: (a) uptake <65%, (b) uptake between 65% and 79%, (c) uptake >80%. The positive predictive value increased significantly with the level of 201Tl uptake, and was suboptimal (46%) in akinetic segments with severely reduced 201Tl uptake. The negative predictive value decreased significantly with 201Tl uptake, and it was less than suboptimal (29%) in akinetic segments with normal tracer uptake. Sensitivity was lower in the subset of akinetic segments (42%-63%) than in all dyssynergic segments (63%-76%), whereas specificity was very high in akinetic segments (80%-84%). It is concluded that the accuracy of low-dose dobutamine echocardiography in predicting reversibility of regional dysfunction varies considerably according to 201Tl uptake at rest and to the severity of regional dysfunction.
*** IBB - CNR ***

Dipartimento di Scienze Biomorfologiche e Funzionali, Università Federico II, Napoli, Italy

Centro C.N.R. Medicina Nucleare, Napoli, Italy

Dipartimento di Medicina Clinica, Scienze Cardiovascolari Ed Immunologiche, Università Federico II, Napoli, Italy

IRCCS Neuromed, Pozzilli, Italy

Trav. Priv. Sanseverino 5/A, 80128, Napoli, Italy

Centro C. N. R. Medicina Nucleare, Napoli, Italy
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Sun, K.T., Czernin, J., Krivokapich, J., Lau, Y.K., Bottcher, M., Maurer, G., Phelps, M.E., Schelbert, H.R., Effects of dobutamine stimulation on myocardial blood flow, glucose metabolism, and wall motion in normal and dysfunctional myocardium (1996) Circulation, 94, pp. 3146-3154

Cigarroa, C. G., DeFilippi, C. R., Brickner, M. E., Alvarez, L. G., Wait, M. A., Grayburn, P. A., Dobutamine stress echocardiography identifies hibernating myocardium and predicts recovery of left ventricular function after coronary revascularization (1993) Circulation, 88, pp. 430-43

Pierard, L. A., De Landsheere, C. M., Berthe, C., Rigo, P., Kulbertus, H. E., Identification of viable myocardium by echocardiography during dobutamine infusion in patients with myocardial infarction after thrombolytic therapy: Comparison with positron emission tomography (1990) J Am Coll Cardiol, 15, pp. 1021-1031

Lee, H. H., Davila-Roman, V. G., Ludbrook, P. A., Courtois, M., Walsh, J. F., Delano, D. A., Rubin, P. J., Gropler, R. J., Dependency of contractile reserve on myocardial blood flow. Implications for the assessment of myocardial viability with dobutamine stress echocardiography (1997) Circulation, 96, pp. 2884-2891

Melon, P. G., De Lansheere, C. M., Degueldre, C., Peters, J. L., Kulbertus, H. E., Pierard, L. A., Relation between contractile reserve and positron emission tomography patterns of perfusion and glucose utilization in chronic ischemic left ventricular dysfunction. Implications for identification of myocardial viability (1997) J Am Coll Cardiol, 30, pp. 1651-1659

Panza, J. A., Dilsizian, V., Curiel, R. V., Unger, E. F., Laurienzo, J. M., Kitsiou, A. N., Myocardial blood flow at rest and contractile reserve in patients with chronic coronary artery disease and left ventricular dysfunction (1999) J Nucl Cardiol, 6, pp. 487-494

Schiller, N. B., Shaha, P. M., Crawford, M., DeMaria, A., Deveroux, R., Feigenbaum, H., Gutgesell, H., Taijik, A. J., Recommendations for quantitation of the left ventricle by two-dimensional echocardiography (1989) J Am Soc Echocardiogr, 2, pp. 358-367

Cornel, J. H., Bax, J. J., Elhendy, A., Maat, A. P. W. M., Kimma, G. J. P., Geleijnse, M. L., Rambaldi, R., Fioretti, P. M., Biphasic response to dobutamine predicts improvement of global left ventricular function after surgical revascularization in patients with stable coronary artery disease. Implications of time course of recovery on diagnostic accuracy (1998) J Am Coll Cardiol, 31, pp. 1002-1010

McGillem, M. J., DeBoe, S. F., Friedman, H. Z., Mancini, G. B. J., The effects of dopamine and dobutamine on regional function in the presence of rigid coronary stenoses and impairments of reactive hyperemia (1988) Am Heart J, 115, pp. 970-977

Gerber, B. L., Vanoverschelde, J. L. J., Bol, A., Michel, C., Labar, D., Wijns, W., Melin, J. A., Myocardial blood flow, glucose uptake, and recruitment of inotropic reserve in chronic left ventricular ischemic dysfunction. Implications for pathophysiology of chronic myocardial hibernation (1996) Circulation, 94, pp. 651-659

Sun, K. T., Czernin, J., Krivokapich, J., Lau, Y. K., Bottcher, M., Maurer, G., Phelps, M. E., Schelbert, H. R., Effects of dobutamine stimulation on myocardial blood flow, glucose metabolism, and wall motion in normal and dysfunctional myocardium (1996) Circulation, 94, pp. 3146-3154

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J Nucl Med (ISSN: 0161-5505, 1535-5667, 1535-5667electronic), 1998 May; 39(5): N/D-N/D.
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Soricelli A, Cuocolo A, Varrone A, Discepolo A, Tedeschi E, Mainenti PP, Grivet-Fojaja MR, Covelli EM, Postiglione A, Salvatore M
Technetium-99m-tetrofosmin uptake in brain tumors by SPECT: Comparison with thallium-201 imaging (88 visite)
J Nucl Med (ISSN: 0161-5505, 1535-5667, 1535-5667electronic), 1998 May; 39(5): 802-806.
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Pace L, Perrone-Filardi P, Mainenti PP, Prastaro M, Cuocolo A, Varrone A, Vezzuto P, Crisci T, Soricelli A, Piscione F, Chiariello M, Salvatore M
Effects of myocardial revascularization on regional thallium-201 uptake and systolic function in regions with reverse redistribution on tomographic thallium-201 imaging at rest in patients with chronic coronary artery disease (108 visite)
J Nucl Cardiol (ISSN: 1071-3581, 1532-6551, 1532-6551electronic), 1998 Mar; 5(2): 153-160.
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Cuocolo A, Nicolai E, Petretta M, Pace L, Cardei S, Varrone A, Trimarco B, Salvatore M
Effects of revascularization on survival and left ventricular function in patients with previous myocardial infarction and evidence of viable myocardium at thallium-201 imaging (86 visite)
J Nucl Med (ISSN: 0161-5505, 1535-5667, 1535-5667electronic), 1997 May; 38(5SUPPL.): N/D-N/D.
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Cuocolo A, Petretta M, Nicolai E, Pace L, Acampa W, Varrone A, Bonaduce D, Salvatore M
Prognostic value of coronary angiography in patients with chronic ischemic left ventricular dysfunction and evidence of viable myocardium at thallium-201 reinjection imaging (99 visite)
J Nucl Med (ISSN: 0161-5505, 1535-5667, 1535-5667electronic), 1997 May; 38(5SUPPL.): 387-395.
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Marcassa C, Galli M, Cuocolo A, Scappellato F, Maurea S, Salvatore M
Rest-redistribution thallium-201 and rest technetium-99m-sestamibi SPECT in patients with stable coronary artery disease and ventricular dysfunction (88 visite)
J Nucl Med (ISSN: 0161-5505, 1535-5667, 1535-5667electronic), 1997; 38(3): 419-424.
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Tedeschi E, Soricelli A, Brunetti A, Romano M, Bucciero A, Iaconetta G, Alfieri A, Postiglione A, Salvatore M
Different thallium-201 single-photon emission tomographic patterns in benign and aggressive meningiomas (136 visite)
Eur J Nucl Med (ISSN: 0340-6997, 1619-7070, 1619-7089), 1996 Nov; 23(11): 1478-1484.
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Maurea S, Cuocolo A, Soricelli A, Castelli L, Nappi A, Trimarco B, Salvatore M
Technetium-99m MIBI SPECT to identify viable myocardium in patients with chronic coronary artery disease and left ventricular dysfunction (99 visite)
Radiol Med (ISSN: 0033-8362, 1826-6983, 1826-6983electronic), 1996; 92(3): 289-296.
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Klain M, Maurea S, Cuocolo A, Colao A, Marzano L, Lombardi G, Salvatore M
Technetium-99m tetrofosmin imaging in thyroid diseases: Comparison with Tc-99m-pertechnetate, thallium-201 and Tc-99m-methioxyisobutylisonitrile scans (93 visite)
Eur J Nucl Med (ISSN: 0340-6997, 1619-7070, 1619-7089), 1996; 23(12): 1568-1574.
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Nicolai E, Cuocolo A, Pace L, Maurea S, Nappi A, Imbriaco M, Morisco C, Argenziano L, Salvatore M
Assessment of systolic wall thickening using technetium-99m methoxyisobutylisonitrile in patients with coronary artery disease: relation to thallium-201 scintigraphy with re-injection (124 visite)
Eur J Nucl Med (ISSN: 0340-6997, 1619-7070, 1619-7089), 1995 Sep; 22(9): 1017-1022.
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Maurea S, Cuocolo A, Nicolai E, Salvatore M
Improved detection of viable myocardium with thallium-201 reinjection in chronic coronary artery disease: comparison with technetium-99m-MIBI imaging (95 visite)
J Nucl Med (ISSN: 0161-5505, 1535-5667, 1535-5667electronic), 1994 Apr; 35(4): 621-624.
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Cuocolo A, Pace L, Maurea S, Ricciardelli B, Nicolai E, Nappi A, Imbriaco M, Trimarco B, Salvatore M
Enhanced thallium-201 uptake after reinjection: Relation to regional ventricular function, myocardial perfusion and coronary anatomy (72 visite)
J Nucl Med Allied Sci, 1994 Mar; 38(1): 6-13.
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Maurea S, Cuocolo A, Pace L, Nicolai E, Nappi A, Imbriaco M, Trimarco B, Salvatore M
Left ventricular dysfunction in coronary artery disease: Comparison between rest-redistribution thallium 201 and resting technetium 99m methoxyisobutyl isonitrile cardiac imaging (106 visite)
J Nucl Cardiol (ISSN: 1071-3581, 1532-6551, 1532-6551electronic), 1994 Jan; 1(1): 65-71.
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Cuocolo A, Maurea S, Pace L, Nicolai E, Nappi A, Imbriaco M, Trimarco B, Salvatore M
Resting technetium-99m methoxyisobutylisonitrile cardiac imaging in chronic coronary artery disease: comparison with rest-redistribution thallium-201 scintigraphy (99 visite)
Eur J Nucl Med (ISSN: 0340-6997, 1619-7070, 1619-7089), 1993 Dec; 20(12): 1186-1192.
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Pace L, Cuocolo A, Maurea S, Nicolai E, Imbriaco M, Nappi A, Morisco C, Chiariello M, Trimarco B, Salvatore M
Reverse redistribution in resting thallium-201 myocardial scintigraphy in patients with coronary artery disease: Relation to coronary anatomy and ventricular function (116 visite)
J Nucl Med (ISSN: 0161-5505, 1535-5667, 1535-5667electronic), 1993 Oct; 34(10): 1688-1692.
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Pace L, Cuocolo A, Stefano ML, Nappi A, Nicolai E, Imbriaco M, Trimarco B, Salvatore M
LEFT-VENTRICULAR SYSTOLIC AND DIASTOLIC FUNCTION MEASUREMENTS USING AN AMBULATORY RADIONUCLIDE MONITOR - EFFECTS OF DIFFERENT TIME AVERAGING ON ACCURACY (76 visite)
J Nucl Med (ISSN: 0161-5505, 1535-5667, 1535-5667electronic), 1993 Sep; 34(9): 1602-1606.
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Maurea S, Cuocolo A, Pace L, Nicolai E, Nappi A, Imbriaco M, Morisco C, Chiariello M, Trimarco B, Salvatore M
Rest-injected thallium-201 redistribution and resting technetium-99m methoxyisobutylisonitrile uptake in coronary artery disease: relation to the severity of coronary artery stenosis (90 visite)
Eur J Nucl Med (ISSN: 0340-6997, 1619-7070, 1619-7089), 1993 Jun; 20(6): 502-510.
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PACE L, CUOCOLO A, NAPPI A, NICOLAI E, TRIMARCO B, SALVATORE M
Accuracy and repeatability of left ventricular systolic and diastolic function measurements using an ambulatory radionuclide monitor (63 visite)
Eur J Nucl Med (ISSN: 0340-6997, 1619-7070, 1619-7089), 1992 Sep; 19(9): 800-806.
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44 Records (37 escludendo Abstract e Conferenze).
Impact factor totale: 112.67 (82.675 escludendo Abstract e Conferenze).
Impact factor a 5 anni totale: 164.972 (121.659 escludendo Abstract e Conferenze).







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