Akut miyokard i̇nfarktüslu hastalarda düşük doz dobutamin ile elde edilen miyokardiyal performans i̇ndeksinin revaskülarizasyon sonrasi miyokard fonksiyonundaki düzelme ile ilişkisi ve miyokard canliliǧini ön görmedeki deǧeri

Aim: This study was planned to evaluate the relationship of the change in the myocardial performance index (MPI) obtained by low dose dobutamine stress echocardiography (DSE) with the myocardial improvement after revascularization and its value in identifying the significant viable myocardial tissue in patients with acute myocardial infarction (AMI). Methods: Forty patients (mean age 57±9 years, 6 female) with Q-AMI, who had no prior myocardial infarction, were enrolled. The wall motion score index (WMSI) and MPI were obtained echocardiographically in basal and low dose DSE in all patients and in the second month after revascularization in 24 revascularized patients. The WMSI was assessed qualitatively by scoring normal to dyskinesia (1 -4 points) according to 16-segments model. Results: The MPI and WMSI obtained by low dose DSE were similar to those after revascularization (0.5±0.14 and 1.24±0.24 vs. 0.52±0.15 and 1.28±0.22, p<0.001 and <0.001; respectively). The change rate (% Δ MPI=17±13 %) in MPI with low dose DSE correlated with that (% Δ DHSI=12±7 %) in WMSI after revascularization (r=0.68, p<0.001). Although the negative predictive value of % Δ MPI ≥ %25 in prediction of the significant viable myocardial tissue was high (96%), its positive predictive value was low (62%). Conclusions: The change rate in MPI with low dose DSE correlates with myocardial healing after revascularization. This rate has a high negative predictive value in prediction of the significant viable myocardial tissue, but its positive predictive value is low. Thus, MPI can be used as an alternative method of WMSI in some cases in when specificity decrease.