Premium
Assessment of Residual Viability by Enoximone Echocardiography in Patients with Previous Myocardial Infarction Correlation with Positron Emission Tomographic Studies and Functional Follow‐Up
Author(s) -
Lu Fei,
Carlino Mauro,
Lu Chunzeng,
Landoni Claudio,
Lucignani Giovanni,
Fragasso Gabriele,
Di Bello Vitantonio,
Margonato Alberto,
Chierchia Sergio L.,
Marzilli Mario,
Balbarini Alberto
Publication year - 2010
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.2009.01082.x
Subject(s) - medicine , positron emission tomography , nuclear medicine , enoximone , concordance , standardized uptake value , concordance correlation coefficient , myocardial infarction , fluorodeoxyglucose , cardiology , heart failure , statistics , mathematics
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 ( 18 F‐FDG) positron emission tomography (PET) and functional follow‐up results. Methods: Twenty‐five patients underwent EE and PET 18 F‐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 18 F‐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 18 F‐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)