Prediction of myocardial recovery by dobutamine magnetic resonance imaging and delayed enhancement early after reperfused acute myocardial infarction |
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Authors: | Achim A Barmeyer Alexander Stork Martin Bansmann Kai Muellerleile Mirko Heuer Markus Bavastro Gerhard Adam Thomas Meinertz Gunnar K Lund |
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Institution: | Clinic of Cardiology/Angiology, University Heart-Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. barmeyer@uke.uni-hamburg.de |
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Abstract: | The purpose was to study dobutamine magnetic resonance cine imaging (DOB-MRI) and delayed myocardial contrast enhancement
(DE) early after reperfused acute myocardial infarction (AMI) for the predicion of segmental myocardial recovery and to find
the optimal dose of dobutamine. Fifty patients (56±12 years, 42 males) with reperfused AMI underwent DOB-MRI and DE studies
3.5 (1–19) days after reperfusion. In DOB-MRI systolic wall thickening (SWT) was measured in 18 segments at rest and during
dobutamine at 5, 10 and 20 μg*kg−1*min−1. Dysfunctional segments were identified and the extent of DE was measured for each segment. Segmental recovery was examined
after 8 (5–15) months. Two hundred-forty-eight segments were dysfunctional with presence of DE in 193. DOB-MRI showed the
best prediction of recovery at 10 μg*kg−1*min−1 of dobutamine with sensitivity of 67%, specificity of 63% and accuracy of 66% using a cut-off value for SWT of 2.0 mm. DE
revealed a sensitivity of 68%, specificity of 65% and accuracy of 67% using a cut-off value of 46%. Combined analysis of DOB-MRI
and DE did not improve diagnostic performance. Early prediction of segmental myocardial recovery after AMI is possible with
DOB-MRI and DE. No improvement is achieved by dobutamine >10 μg*kg−1*min−1 or a combination of DOB-MRI and DE. |
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Keywords: | Myocardial recovery Dobutamine Delayed enhancement Magnetic resonance imaging Acute myocardial infarction |
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