Clinical Utility of Low Dose Dobutamine Echocardiography in Regional Myocardial Viability Detection Before and After Surgical Revascularization

Abstract

Low dose DSE results in high clinical utility by finding viable or scar myocardium before CABG as well as when discordant results are found in follow-up, particularly with Fp.

Magnetic Resonance Imaging

“…Stress echocardiography may have a role in differentiating viable from scarred myocardium before coronary artery bypass graft. 33 On MRI, injured myocardium shows delayed enhancement after injection of gadolinium chelates. The infarct size may be overestimated or underestimated, depending on multiple factors including the extent of the infarct, collateral circulation, and the timing and dose of contrast given.…”

Assessment of Residual Viability by Enoximone Echocardiography in Patients with Previous Myocardial Infarction Correlation with Positron Emission Tomographic Studies and Functional Follow‐Up

“…Assessment of residual myocardial viability in postinfarction patients is crucial for decision making in further treatment. The presence of contractile reserve demonstrated by inotropic simulation, such as low‐dose dobutamine, has been proposed as a marker of myocardial viability 1,2 . However, dobutamine‐induced inotropic response is based on adrenergic stimulation and can be attenuated in patients treated with β‐adrenoceptor blockers.…”

“…The presence of contractile reserve demonstrated by inotropic simulation, such as low-dose dobutamine, has been proposed as a marker of myocardial viability. 1,2 However, dobutamine-induced inotropic response is based on adrenergic stimulation and can be attenuated in patients treated with β-adrenoceptor blockers. Furthermore, in the presence of critical coronary stenosis, dobutamine, even at low doses, can sometimes induce ischemia that might mask a hibernating state by preventing the improvement of wall motion.…”