Spontaneous improvement of contraction and perfusion occurs after acute myocardial infarction. The relative merit of low-dose dobutamine stress echocardiography (LDDE) and rest-redistribution thallium scintigraphy (RR Tl) in this setting has not been evaluated. We studied 30 patients at 7 ± 3 days after acute myocardial infarction with LDDE (5 to 10 μg/kg/min) and RR Tl single photon emission computed tomography. Viability was defined as improvement of wall thickening at LDDE in the presence of redistribution or a defect with uptake ≥50% of peak activity at RR Tl. Baseline echocardiography and RR Tl were repeated after 3 months. In 112 dyssynergic segments, viability was detected in 60 (54%) by RR Tl and in 39 (35%) by LDDE (p < 0.005). Spontaneous improvement of function was detected in 35 (31%) segments. In the same regions, thallium uptake increased significantly. The sensitivity, specificity, and accuracy of LDDE for predicting late improvement of wall motion were 77%, 84%, and 82%, respectively. Those of RR Tl were 77%, 57%, and 63%, respectively. Specificity and accuracy of LDDE were higher than RR Tl (p < 0.005). We conclude that a myocardial viability pattern after acute myocardial infarction is more frequently detected by RR Tl than by LDDE. Both techniques are equally sensitive, but LDDE is a more specific predictor of spontaneous recovery of regional left ventricular function.

Additional Metadata
Persistent URL dx.doi.org/10.1016/S0002-8703(96)90082-4, hdl.handle.net/1765/58501
Journal American Heart Journal
Citation
Elhendy, A, Trocino, G, Salustri, A, Cornel, J.H, Roelandt, J.R.T.C, Boersma, H, … Fioretti, P.M. (1996). Low-dose dobutamine echocardiography and rest-redistribution thallium-201 tomography in the assessment of spontaneous recovery of left ventricular function after recent myocardial infarction. American Heart Journal, 131(6), 1088–1096. doi:10.1016/S0002-8703(96)90082-4