Ischemia-induced regional wall motion abnormality is improved after coronary angioplasty: Demonstration by dobutamine stress echocardiography

Kwame Osei Akosah, Thomas R. Porter, Ramona Simon, John T. Funai, Anthony J. Minisi, Pramod K. Mohanty

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objectives. The purpose of this study was to examine whether dobutamine stress echocardiography can detect reversal of ischemia-induced left ventricular regional wall motion abnormality immediately after percutaneous transluminal coronary angiopiasty. Background. Although angioplasty is routinely performed as a means of coronary revascularization, at present there is a question whether this results in an immediate improvement in ischemia-induced left ventricular regional function. Methods. Thirty-five patients underwent dobutamine stress echocardiography 24 h before and 24 to 48 h after angiographically successful coronary angioplasty. Only patients with normal wall motion at rest were included. Dobutamine infusion was begun at 5 μg/kg per min and increased at 5-min intervals (10, 20, 30, 40 μg/kg per min). Echocardiographic images were stored into cine loops and analyzed off line with simultaneous comparison of images acquired at baseline, 5 μg/kg per min, peak infusion and recovery. Echocardiographic images were interpreted independently, without knowledge of other data, by two experienced cardiologists using the 16-myocardial segment model. Results. Before angioplasty, dobutamine stress echocardiography induced wall motion abnormalities in 31 patients (88%). Wall motion score at peak dobutamine infusion improved in 28 (90%) of the 31 patients after angioplasty. Wall motion score at peak dobutamine infusion for the group improved from 20 ± 3 before angioplasty to 17 ± 2 after angioplasty (p < 0.001). There was no change in the rate-pressure product achieved for the group before and after angioplasty (20,038 ± 6,415 beats/min × mm Hg before versus 20,775 ± 5,435 after angioplasty, p = NS). Before angioplasty, dobutamine stress echocardiography induced angina in 13 patients (37%), whereas angina occurred only once after angioplasty. Electrocardiographic changes diagnostic of ischemia occurred seven times, all before angioplasty. Conclusions. We conclude that dobutamine stress echocardiography is an excellent method to demonstrate an immediate improvement in stress-induced regional left ventricular dysfunction in the distribution of the vessel undergoing successful angioplasty.

Original languageEnglish (US)
Pages (from-to)584-589
Number of pages6
JournalJournal of the American College of Cardiology
Volume21
Issue number3
DOIs
StatePublished - Mar 1 1993

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Stress Echocardiography
Angioplasty
Ischemia
Dobutamine
Left Ventricular Dysfunction
Left Ventricular Function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Ischemia-induced regional wall motion abnormality is improved after coronary angioplasty : Demonstration by dobutamine stress echocardiography. / Akosah, Kwame Osei; Porter, Thomas R.; Simon, Ramona; Funai, John T.; Minisi, Anthony J.; Mohanty, Pramod K.

In: Journal of the American College of Cardiology, Vol. 21, No. 3, 01.03.1993, p. 584-589.

Research output: Contribution to journalArticle

Akosah, Kwame Osei ; Porter, Thomas R. ; Simon, Ramona ; Funai, John T. ; Minisi, Anthony J. ; Mohanty, Pramod K. / Ischemia-induced regional wall motion abnormality is improved after coronary angioplasty : Demonstration by dobutamine stress echocardiography. In: Journal of the American College of Cardiology. 1993 ; Vol. 21, No. 3. pp. 584-589.
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abstract = "Objectives. The purpose of this study was to examine whether dobutamine stress echocardiography can detect reversal of ischemia-induced left ventricular regional wall motion abnormality immediately after percutaneous transluminal coronary angiopiasty. Background. Although angioplasty is routinely performed as a means of coronary revascularization, at present there is a question whether this results in an immediate improvement in ischemia-induced left ventricular regional function. Methods. Thirty-five patients underwent dobutamine stress echocardiography 24 h before and 24 to 48 h after angiographically successful coronary angioplasty. Only patients with normal wall motion at rest were included. Dobutamine infusion was begun at 5 μg/kg per min and increased at 5-min intervals (10, 20, 30, 40 μg/kg per min). Echocardiographic images were stored into cine loops and analyzed off line with simultaneous comparison of images acquired at baseline, 5 μg/kg per min, peak infusion and recovery. Echocardiographic images were interpreted independently, without knowledge of other data, by two experienced cardiologists using the 16-myocardial segment model. Results. Before angioplasty, dobutamine stress echocardiography induced wall motion abnormalities in 31 patients (88{\%}). Wall motion score at peak dobutamine infusion improved in 28 (90{\%}) of the 31 patients after angioplasty. Wall motion score at peak dobutamine infusion for the group improved from 20 ± 3 before angioplasty to 17 ± 2 after angioplasty (p < 0.001). There was no change in the rate-pressure product achieved for the group before and after angioplasty (20,038 ± 6,415 beats/min × mm Hg before versus 20,775 ± 5,435 after angioplasty, p = NS). Before angioplasty, dobutamine stress echocardiography induced angina in 13 patients (37{\%}), whereas angina occurred only once after angioplasty. Electrocardiographic changes diagnostic of ischemia occurred seven times, all before angioplasty. Conclusions. We conclude that dobutamine stress echocardiography is an excellent method to demonstrate an immediate improvement in stress-induced regional left ventricular dysfunction in the distribution of the vessel undergoing successful angioplasty.",
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T1 - Ischemia-induced regional wall motion abnormality is improved after coronary angioplasty

T2 - Demonstration by dobutamine stress echocardiography

AU - Akosah, Kwame Osei

AU - Porter, Thomas R.

AU - Simon, Ramona

AU - Funai, John T.

AU - Minisi, Anthony J.

AU - Mohanty, Pramod K.

PY - 1993/3/1

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N2 - Objectives. The purpose of this study was to examine whether dobutamine stress echocardiography can detect reversal of ischemia-induced left ventricular regional wall motion abnormality immediately after percutaneous transluminal coronary angiopiasty. Background. Although angioplasty is routinely performed as a means of coronary revascularization, at present there is a question whether this results in an immediate improvement in ischemia-induced left ventricular regional function. Methods. Thirty-five patients underwent dobutamine stress echocardiography 24 h before and 24 to 48 h after angiographically successful coronary angioplasty. Only patients with normal wall motion at rest were included. Dobutamine infusion was begun at 5 μg/kg per min and increased at 5-min intervals (10, 20, 30, 40 μg/kg per min). Echocardiographic images were stored into cine loops and analyzed off line with simultaneous comparison of images acquired at baseline, 5 μg/kg per min, peak infusion and recovery. Echocardiographic images were interpreted independently, without knowledge of other data, by two experienced cardiologists using the 16-myocardial segment model. Results. Before angioplasty, dobutamine stress echocardiography induced wall motion abnormalities in 31 patients (88%). Wall motion score at peak dobutamine infusion improved in 28 (90%) of the 31 patients after angioplasty. Wall motion score at peak dobutamine infusion for the group improved from 20 ± 3 before angioplasty to 17 ± 2 after angioplasty (p < 0.001). There was no change in the rate-pressure product achieved for the group before and after angioplasty (20,038 ± 6,415 beats/min × mm Hg before versus 20,775 ± 5,435 after angioplasty, p = NS). Before angioplasty, dobutamine stress echocardiography induced angina in 13 patients (37%), whereas angina occurred only once after angioplasty. Electrocardiographic changes diagnostic of ischemia occurred seven times, all before angioplasty. Conclusions. We conclude that dobutamine stress echocardiography is an excellent method to demonstrate an immediate improvement in stress-induced regional left ventricular dysfunction in the distribution of the vessel undergoing successful angioplasty.

AB - Objectives. The purpose of this study was to examine whether dobutamine stress echocardiography can detect reversal of ischemia-induced left ventricular regional wall motion abnormality immediately after percutaneous transluminal coronary angiopiasty. Background. Although angioplasty is routinely performed as a means of coronary revascularization, at present there is a question whether this results in an immediate improvement in ischemia-induced left ventricular regional function. Methods. Thirty-five patients underwent dobutamine stress echocardiography 24 h before and 24 to 48 h after angiographically successful coronary angioplasty. Only patients with normal wall motion at rest were included. Dobutamine infusion was begun at 5 μg/kg per min and increased at 5-min intervals (10, 20, 30, 40 μg/kg per min). Echocardiographic images were stored into cine loops and analyzed off line with simultaneous comparison of images acquired at baseline, 5 μg/kg per min, peak infusion and recovery. Echocardiographic images were interpreted independently, without knowledge of other data, by two experienced cardiologists using the 16-myocardial segment model. Results. Before angioplasty, dobutamine stress echocardiography induced wall motion abnormalities in 31 patients (88%). Wall motion score at peak dobutamine infusion improved in 28 (90%) of the 31 patients after angioplasty. Wall motion score at peak dobutamine infusion for the group improved from 20 ± 3 before angioplasty to 17 ± 2 after angioplasty (p < 0.001). There was no change in the rate-pressure product achieved for the group before and after angioplasty (20,038 ± 6,415 beats/min × mm Hg before versus 20,775 ± 5,435 after angioplasty, p = NS). Before angioplasty, dobutamine stress echocardiography induced angina in 13 patients (37%), whereas angina occurred only once after angioplasty. Electrocardiographic changes diagnostic of ischemia occurred seven times, all before angioplasty. Conclusions. We conclude that dobutamine stress echocardiography is an excellent method to demonstrate an immediate improvement in stress-induced regional left ventricular dysfunction in the distribution of the vessel undergoing successful angioplasty.

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