116 Contractility reserve in segments non-viable on delayed enhancement; analysis with low dose dobutamine MRI
Journal of Cardiovascular Magnetic Resonance volume 10, Article number: A17 (2008)
Transmural extent of infarction (TEI) of >50% on delayed enhancement (DE) images is considered as non-viable and as a result not revascularised.
To investigate the contractility reserve before revascularisation of a chronic total coronary occlusion (CTO).
Methods and materials
Dobutamine stress leads to an increase in systolic wall thickening in viable tissue. Forty-seven patients with a CTO of a coronary artery were included. Segmental wall thickening (SWT) at rest and during dobutamine stress (5 and 10 microg/kg/min) were evaluated. DE-images were performed to calculate the TEI. Segments were scored as dysfunctional if SWT was <45%.
Seventy percent (151/216) of the segments in patients with a CTO were dysfunctional. Mean SWT of all CTO perfused segments was 35% ± 34% which was significantly lower compared to remote segments; 52 ± 48% (p < 0.001). Dysfunctional segments with a TEI<50% showed a significant improvement in SWT with 5 microg/kg/min dobutamine. Interestingly segments with TEI 50%–75% showed a significant improvement in SWT were a higher dose was used (Figure 1).
Contractility reserve is present in segments with TEI<50% and 50%–75% although a higher dose was needed when TEI 50%–75%.
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Kirschbaum, S.W., Gruszczynska, K., Krestin, G.P. et al. 116 Contractility reserve in segments non-viable on delayed enhancement; analysis with low dose dobutamine MRI. J Cardiovasc Magn Reson 10 (Suppl 1), A17 (2008). https://doi.org/10.1186/1532-429X-10-S1-A17