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116 Contractility reserve in segments non-viable on delayed enhancement; analysis with low dose dobutamine MRI

Background

Transmural extent of infarction (TEI) of >50% on delayed enhancement (DE) images is considered as non-viable and as a result not revascularised.

Purpose

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%.

Results

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).

Figure 1
figure1

All dysfunctional CTO segments. Contractility reserve in segments non-viable on delayed enhancement; analysis with low dose dobutamine MRI. This was observed as an increase in segmental wall thickening in segments with TEI<50% and 50%–75% although a higher dose was needed when TEI 50%–75%.

Conclusion

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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Correspondence to Sharon WM Kirschbaum.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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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, A17 (2008). https://doi.org/10.1186/1532-429X-10-S1-A17

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Keywords

  • Public Health
  • Coronary Artery
  • Wall Thickening
  • Dobutamine
  • Coronary Occlusion