Low‑dose dobutamine stress myocardial contrast echocardiography for the evaluation of myocardial microcirculation and prediction of overall cardiac function recovery

Lin,Yunjia; Guan,Xin; Ren,Kai; Zhu,Yanbo; Lu,Yaping; Shang, Yanwen

doi:10.3892/etm.2020.8813

Low‑dose dobutamine stress myocardial contrast echocardiography for the evaluation of myocardial microcirculation and prediction of overall cardiac function recovery

Authors:
- Yunjia Lin
- Xin Guan
- Kai Ren
- Yanbo Zhu
- Yaping Lu
- Yanwen Shang
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Affiliations: Department of Ultrasound, Tianjin Chest Hospital, Tianjin 300222, P.R. China, Cardiac Intensive Care Unit, Tianjin Chest Hospital, Tianjin 300222, P.R. China
Published online on: May 28, 2020 https://doi.org/10.3892/etm.2020.8813
Pages: 1315-1320
Copyright: © Lin et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The study aimed to investigate the role of low‑dose dobutamine stress myocardial contrast echocardiography (MCE) in evaluating myocardial local microcirculation and predicting cardiac function recovery in patients with myocardial infarction. A total of 50 patients with acute myocardial infarction (AMI) were enrolled in the present study. Positron emission tomography was used as a gold standard to determine viable/non‑viable myocardial segments in infarcted myocardial region. MCE and dobutamine stress MCE were carried out 72 h after PCI. MCE was carried out again to evaluate myocardial condition at 6 months after PCI. As compared with normal myocardial segments, resting MCE revealed a significant decrease of the values of A (the peak intensity of the time‑perfusion intensity curve, reflecting the myocardial blood volume), β (the slope of the curve, reflecting the myocardial blood flow (MBF) velocity) and A x β (reflecting MBF) of viable and non‑viable myocardial segments. After being challenged by dobutamine, the values of A, β and A x β of normal coronary blood supply areas were significantly increased; while the segments A and A x β of viable myocardium were markedly decreased. Patients were further divided into two groups based on the changes in the contrast‑enhanced index (CSI) following dobutamine loading. In the dobutamine stress echocardiography‑positive group (the CSI increased or decreased by >0.2), the left ventricular ejection fraction was significantly increased and pro‑B‑type natriuretic peptide significantly decreased at 6 months following intervention. Low‑dose dobutamine stress MCE was indicated to be an effective method to evaluate myocardial microcirculation perfusion in patients with AMI following PCI. In addition, CSI, as a simple semi‑quantitative index, may predict left ventricular function in patients with AMI.

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