Diagnostic value of dobutamine echocardiography in patients with acute or old myocardial infarction

Background: The loss of myocardial viability increases progressively after an episode of acute myocardial infarction (MI). Variation in timing of tests is likely to affect the diagnostic value of dobutamine echocardiography (DE). Materials and Methods: DE was performed in 284 patients (154 with acute and 130 with old MI). The diagnostic value of DE in coronary artery diseases at the infarct or the non-infarct area was evaluated by comparing the results to findings on coronary angiography. Results: Compared to the old MI group, acute MI patients showed a better response to DE (56.2% vs 79.2%; p < 0.0001). DE in the acute MI group also demonstrated a significantly higher sensitivity and accuracy in detecting coronary artery stenosis at both the infarct area and the non-infarct area. However, there was no significant difference in the specificity and the positive predictive values. Conclusion: DE performed at an early stage after acute MI provides better diagnostic value, and this may be due to the increased amount of loss of viable tissue at the infarct area with time. DE has a low diagnostic value in the non- infarcted area as a result of increased impairment to contractility caused by time-related ventricular remodeling or progressive coronary disease.