Dobutamine Echocardiography Predicts Improvement of Hypoperfused Dysfunctional Myocardium After Revascularization in Patients With Coronary Artery Disease

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Abstract
Background In patients with coronary artery disease, dysfunctional hypoperfused myocardium at rest may represent either necrotic or viable hibernating myocardium. The accuracy of inotropic stimulation in identifying hypoperfused, reversibly dysfunctional myocardium has not been extensively investigated. Methods and Results Eighteen patients with stable chronic coronary artery disease underwent, while off drugs, quantitative 201Tl single-photon emission computed tomography after rest injection (2 to 3 mCi), two-dimensional echocardiography at rest and during dobutamine (5 to 10 μg/kg per minute IV), and radionuclide angiography. Single-photon emission computed tomography and echocardiography at rest were repeated 34±10 days after coronary revascularization, and radionuclide angiography was repeated 45±13 days after revascularization. Resting hypoperfusion was defined as 201Tl uptake <80% of maximal activity. Systolic function was scored from 1 (normal) to 4 (dyskinesia), and functional improvement was defi...

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