EFFECTS OF LOW DOSE DOBUTAMINE ON DISPLACEMENT OF THE ATRIOVENTRICULAR PLANE AND ASSESSMENT OF MYOCARDIAL VIABILITY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Abstract

Regional and/or gl obal dysfunction follows AMI in most cases. Early thrombolysis may decrease infarction size and sal vage left ventricular function. However, demonstration of improved left ventricular function can be delayed due to prolonged post-ischemic ventricular dysfunction. The cardiac tissue in the stunned myocardium is viable and has a contractile reserve (Samad et al., 1999).

Clinical studies showed low dose dobutamine infusion combined with 2D echocardiography to be a simple method, which identifies the areas of myocardial viability with significant accuracy (Barilla et al., 1991).

Previous echocardiographic studies have highlighted the usefulness of atrioventricular plane displacement (AVPD) in assessmg left ventricular function at rest (Aiam et al., 1990 & 1992).

In the present work, we studied the effects of dobutamine stress on AVPD to assess the viability in patients with AMI.

The present study included thirty patients with AMI, having resting wall motion abnormalities at the infarct site. The patients were studied with rest & LDDSE before discharge. Ten patients served as control subjects for rest echocardiography. Nineteen patients were followed up six months later with rest echocardiography.