Prospective Study of Dobutamine Stress Echocardiography in Comparison with 18F-fluorodeoxyglucose Positron Emission Tomography for Myocardial Viability in Ischemic Cardiomyopathy
Background: Myocardial viability is utilized in the decision-making process for suitability of revascularization in patients with coronary artery disease and depressed left ventricular (LV) function. Aims: The aim of this study was to compare the accuracy of dobutamine stress echocardiography (DSE)...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-12-01
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| Series: | Journal of Indian College of Cardiology |
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| Online Access: | https://journals.lww.com/10.4103/jicc.jicc_70_24 |
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| author | Nuthalapati Rama Kumari Arumulla Sunitha Sama Rajashekhar |
| author_facet | Nuthalapati Rama Kumari Arumulla Sunitha Sama Rajashekhar |
| author_sort | Nuthalapati Rama Kumari |
| collection | DOAJ |
| description | Background:
Myocardial viability is utilized in the decision-making process for suitability of revascularization in patients with coronary artery disease and depressed left ventricular (LV) function.
Aims:
The aim of this study was to compare the accuracy of dobutamine stress echocardiography (DSE) with the 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) for the identification of viable myocardium in patients with previous myocardial infarction and LV dysfunction.
Settings and Design:
This was a prospective observational study done at Nizam’s Institute of Medical Sciences.
Materials and Methods:
Patients with coronary artery disease with previous myocardial infarction with significant LV dysfunction were included in the study.
Statistical Analysis:
Categorical variables were presented in number and percentage (%), and continuous variables were presented as mean ± standard deviation. Student’s paired t-test was applied to test the difference between the outcomes of 18F-FDG PET and dobutamine stress echo. The statistical software SPSS 17.0 version was used in the analysis of the data.
Results:
In our study population, the mean LV ejection fraction was 35.1%. A total of 800 myocardial segments were evaluated with resting two-dimensional echocardiography examination, of which 250 (31.2%) were normal and 550 (68.8%) were abnormal segments. The dysfunctional 550 segments were further assessed with DSE followed by 18F-FDG PET. In our study, 453 segments were viable on 18F-FDG PET and 407 segments viable on DSE (P = 0.001). Viability was detected by both modalities in 88.1% and discordance in 11.9% of segments. These results yielded a positive predictive value of 97.8% and negative predictive value of 61.1% of DSE.
Conclusions:
On considering 18F-FDG PET a gold standard for detection of viable myocardial segments, DSE has shown a sensitivity of 87.6% and specificity of 90.7%. Thus, DSE can be used as a good alternate to 18F-FDG PET where facility for FDG PET is not available. However, patients detected to have nonviable dysfunctional segments on DSE can be evaluated further with 18F-FDG PET for confirmation of viability. |
| format | Article |
| id | doaj-art-016f758aed254e95bbec4bea33594c27 |
| institution | Kabale University |
| issn | 1561-8811 2213-3615 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Indian College of Cardiology |
| spelling | doaj-art-016f758aed254e95bbec4bea33594c272025-01-12T10:26:33ZengWolters Kluwer Medknow PublicationsJournal of Indian College of Cardiology1561-88112213-36152024-12-0114411912410.4103/jicc.jicc_70_24Prospective Study of Dobutamine Stress Echocardiography in Comparison with 18F-fluorodeoxyglucose Positron Emission Tomography for Myocardial Viability in Ischemic CardiomyopathyNuthalapati Rama KumariArumulla SunithaSama RajashekharBackground: Myocardial viability is utilized in the decision-making process for suitability of revascularization in patients with coronary artery disease and depressed left ventricular (LV) function. Aims: The aim of this study was to compare the accuracy of dobutamine stress echocardiography (DSE) with the 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) for the identification of viable myocardium in patients with previous myocardial infarction and LV dysfunction. Settings and Design: This was a prospective observational study done at Nizam’s Institute of Medical Sciences. Materials and Methods: Patients with coronary artery disease with previous myocardial infarction with significant LV dysfunction were included in the study. Statistical Analysis: Categorical variables were presented in number and percentage (%), and continuous variables were presented as mean ± standard deviation. Student’s paired t-test was applied to test the difference between the outcomes of 18F-FDG PET and dobutamine stress echo. The statistical software SPSS 17.0 version was used in the analysis of the data. Results: In our study population, the mean LV ejection fraction was 35.1%. A total of 800 myocardial segments were evaluated with resting two-dimensional echocardiography examination, of which 250 (31.2%) were normal and 550 (68.8%) were abnormal segments. The dysfunctional 550 segments were further assessed with DSE followed by 18F-FDG PET. In our study, 453 segments were viable on 18F-FDG PET and 407 segments viable on DSE (P = 0.001). Viability was detected by both modalities in 88.1% and discordance in 11.9% of segments. These results yielded a positive predictive value of 97.8% and negative predictive value of 61.1% of DSE. Conclusions: On considering 18F-FDG PET a gold standard for detection of viable myocardial segments, DSE has shown a sensitivity of 87.6% and specificity of 90.7%. Thus, DSE can be used as a good alternate to 18F-FDG PET where facility for FDG PET is not available. However, patients detected to have nonviable dysfunctional segments on DSE can be evaluated further with 18F-FDG PET for confirmation of viability.https://journals.lww.com/10.4103/jicc.jicc_70_24dobutamine stress echocardiographyfluorodeoxyglucose positron emission tomographymyocardial viability |
| spellingShingle | Nuthalapati Rama Kumari Arumulla Sunitha Sama Rajashekhar Prospective Study of Dobutamine Stress Echocardiography in Comparison with 18F-fluorodeoxyglucose Positron Emission Tomography for Myocardial Viability in Ischemic Cardiomyopathy Journal of Indian College of Cardiology dobutamine stress echocardiography fluorodeoxyglucose positron emission tomography myocardial viability |
| title | Prospective Study of Dobutamine Stress Echocardiography in Comparison with 18F-fluorodeoxyglucose Positron Emission Tomography for Myocardial Viability in Ischemic Cardiomyopathy |
| title_full | Prospective Study of Dobutamine Stress Echocardiography in Comparison with 18F-fluorodeoxyglucose Positron Emission Tomography for Myocardial Viability in Ischemic Cardiomyopathy |
| title_fullStr | Prospective Study of Dobutamine Stress Echocardiography in Comparison with 18F-fluorodeoxyglucose Positron Emission Tomography for Myocardial Viability in Ischemic Cardiomyopathy |
| title_full_unstemmed | Prospective Study of Dobutamine Stress Echocardiography in Comparison with 18F-fluorodeoxyglucose Positron Emission Tomography for Myocardial Viability in Ischemic Cardiomyopathy |
| title_short | Prospective Study of Dobutamine Stress Echocardiography in Comparison with 18F-fluorodeoxyglucose Positron Emission Tomography for Myocardial Viability in Ischemic Cardiomyopathy |
| title_sort | prospective study of dobutamine stress echocardiography in comparison with 18f fluorodeoxyglucose positron emission tomography for myocardial viability in ischemic cardiomyopathy |
| topic | dobutamine stress echocardiography fluorodeoxyglucose positron emission tomography myocardial viability |
| url | https://journals.lww.com/10.4103/jicc.jicc_70_24 |
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