(Circulation. 1995;91:663-670.)
© 1995 American Heart Association, Inc.
Articles |
Dobutamine Echocardiography in Myocardial Hibernation
Optimal Dose and Accuracy in Predicting Recovery of Ventricular Function After Coronary Angioplasty
Presented in part at the 66th Annual Scientific Session of the American Heart Association, November 1993, Atlanta, Ga.
From the Section of Cardiology, Department of Medicine, Baylor College of Medicine, The Methodist Hospital, Echocardiography Laboratory, Houston, Tex.
Correspondence to William A. Zoghbi, MD, The Methodist Hospital, Section of Cardiology, 6535 Fannin, F905, Houston, TX 77030.
Background Myocardial hibernation is a condition of chronic left ventricular dysfunction associated with severe coronary artery disease whereby significant recovery of function occurs after revascularization. Identification of hibernating myocardium has important prognostic and therapeutic implications. The presence of contractile reserve as assessed by dobutamine echocardiography may be promising in the detection of hibernation. We designed a prospective study to evaluate the accuracy and optimal dose of dobutamine echocardiography for predicting recovery of ventricular function after angioplasty in patients with stable coronary artery disease and ventricular dysfunction.
Methods and Results Twenty patients with stable coronary artery
disease and segmental ventricular dysfunction scheduled for coronary
angioplasty underwent dobutamine echocardiography before
revascularization using incremental doses of 2.5, 5, 7.5, 10, 20, 30,
and 40 µg/kg per minute every 3 minutes. Digital images of all eight
stages were displayed simultaneously (two quad screens side by side)
and interpreted using a 16-segment ventricular model and a 6-grade
scoring system. Serial resting echocardiograms before, early (<1
week), and late (
6 weeks) after angioplasty were digitized and
randomized in a quad-screen format for the assessment of recovery of
function. Wall motion score index in the revascularized regions
decreased from 2.86±0.76 before angioplasty to 2.12±1.03 late
after
angioplasty (P<.05). Of 320 ventricular segments, 148 had
abnormal wall motion at baseline and 114 were revascularized. Recovery
of function (2 grades) occurred in 25% of revascularized segments
early and in 33% late after angioplasty. Of the 34 abnormal segments
not revascularized, recovery of function occurred in only 1. During
dobutamine echocardiography, abnormal segments exhibited one of four
responses: biphasic (improvement at low dose and worsening at high
dose) in 28% of segments, sustained improvement (persistent
improvement till peak dose) in 18%, worsening in 15%, and no change
in 39%. A biphasic response had the highest predictive value (72%)
for recovery of function followed by worsening only (35%), while the
lowest was seen with a "no change" or sustained improvement
response (13% and 15%). Combining biphasic and worsening responses
resulted in a sensitivity of 74% and specificity of 73% for
assessment of recovery of individual segments and 90% and 60%,
respectively, for functional recovery of individual patients (n=10). In
segments with a biphasic response, the low dose at which improvement in
wall motion was most prevalent (84%) was 7.5 µg/kg per minute and
increased to 94% when the 5 and 7.5 µg/kg per minute doses were
displayed. The reworsening phase of the biphasic response was usually
seen with doses 20 µg/kg per minute but was also observed as early
as the 7.5 µg/kg per minute dose.
Conclusions The wall motion response during dobutamine echocardiography is useful in the prediction of recovery of ventricular function after revascularization in patients with stable coronary artery disease and ventricular dysfunction. The administration of low as well as high doses of dobutamine is needed for optimal evaluation.
Key Words: echocardiography • coronary disease • myocardium • angioplasty
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|
|
|
|
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|
|
|
|
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|
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|
|
|
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|
|
|
|
|
|
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|
|
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|
|
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|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
 A. F.M van den Heuvel, J. J Bax, P. K Blanksma, W. Vaalburg, H. J.G.M Crijns, and D. J van Veldhuisen Abnormalities in myocardial contractility, metabolism and perfusion reserve in non-stenotic coronary segments in heart failure patients Cardiovasc Res, July 1, 2002; 55(1): 97 - 103. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
 |
|
 G. C. Hughes, C. K. Landolfo, B. Yin, T. R. DeGrado, R. E. Coleman, K. P. Landolfo, and J. E. Lowe Is chronically dysfunctional yet viable myocardium distal to a severe coronary stenosis hypoperfused? Ann. Thorac. Surg., July 1, 2001; 72(1): 163 - 168. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Iglesias-Garriz, F.e. Corral, M. A. Rodriguez, C. Garrote, M. Montes, and E. Sevillano Pre-infarction angina elicits greater myocardial viability on reperfusion after myocardial infarction: a dobutamine stress echocardiographic study J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1846 - 1850. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
 |
|
 R Sicari, A Ripoli, E Picano, A.C Borges, A Varga, W Mathias, L Cortigiani, R Bigi, J Heyman, S Polimeno, et al. The prognostic value of myocardial viability recognized by low dose dipyridamole echocardiography in patients with chronic ischaemic left ventricular dysfunction Eur. Heart J., May 2, 2001; 22(10): 837 - 844. [Abstract] [PDF]
|
|
|
|
|
|
P Lancellotti, A Albert, C Berthe, and L A Piérard Full recovery of contraction late after acute myocardial infarction: determinants and early predictors Heart, May 1, 2001; 85(5): 521 - 526. [Abstract] [Full Text]
|
|
|
|
|
|
Y. Yong, S. F. Nagueh, S. Shimoni, K. Shan, Z.-X. He, M. J. Reardon, G. V. Letsou, J. F. Howell, M. S. Verani, M. A. Quinones, et al. Deceleration Time in Ischemic Cardiomyopathy : Relation to Echocardiographic and Scintigraphic Indices of Myocardial Viability and Functional Recovery After Revascularization Circulation, March 6, 2001; 103(9): 1232 - 1237. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-M. J. Siebelink, P. K. Blanksma, H. J. G. M. Crijns, J. J. Bax, A. J. van Boven, T. Kingma, D. A. Piers, J. Pruim, P. L. Jager, W. Vaalburg, et al. No difference in cardiac event-free survival between positron emission tomography-guided and single-photon emission computed tomography-guided patient management: A prospective, randomized comparison of patients with suspicion of jeopardized myocardium J. Am. Coll. Cardiol., January 1, 2001; 37(1): 81 - 88. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Wolf, L. Gepstein, G. Hayam, A. Zaretzky, R. Shofty, D. Kirshenbaum, G. Uretzky, U. Oron, and S. A. Ben-Haim Three-dimensional endocardial impedance mapping: a new approach for myocardial infarction assessment Am J Physiol Heart Circ Physiol, January 1, 2001; 280(1): H179 - H188. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-P. Bin, R. A. Pelberg, K. Wei, M. Coggins, N. C. Goodman, and S. Kaul Relation between regional function and coronary blood flow reserve in multivessel coronary artery stenosis Am J Physiol Heart Circ Physiol, December 1, 2000; 279(6): H3058 - H3064. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Shan, R. J. Bick, B. J. Poindexter, S. F. Nagueh, S. Shimoni, M. S. Verani, F. Keng, M. J. Reardon, G. V. Letsou, J. F. Howell, et al. Altered Adrenergic Receptor Density in Myocardial Hibernation in Humans : A Possible Mechanism of Depressed Myocardial Function Circulation, November 21, 2000; 102(21): 2599 - 2606. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G LaCanna, S.H Rahimtoola, O Visioli, R Giubbini, O Alfieri, M Zognio, E Milan, C Ceconi, M Gargano, R LoRusso, et al. Sensitivity, specificity, and predictive accuracies of non-invasive tests, singly and in combination, for diagnosis of hibernating myocardium Eur. Heart J., August 2, 2000; 21(16): 1358 - 1367. [Abstract] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
F. Barilla Reply J. Am. Coll. Cardiol., January 1, 2000; 35(1): 258 - 259. [Full Text] [PDF]
|
|
|
|
|
|
R J Trent, G D Waiter, G S Hillis, F I McKiddie, T W Redpath, and S Walton Dobutamine magnetic resonance imaging as a predictor of myocardial functional recovery after revascularisation Heart, January 1, 2000; 83(1): 40 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
F. A. Chaudhry, J. T. Tauke, R. S. Alessandrini, G. Vardi, M. A. Parker, and R. O. Bonow Prognostic implications of myocardial contractile reserve in patients with coronary artery disease and left ventricular dysfunction J. Am. Coll. Cardiol., September 1, 1999; 34(3): 730 - 738. [Abstract] [Full Text] [PDF]
|
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S. F. Nagueh, I. Mikati, D. Weilbaecher, M. J. Reardon, G. J. Al-Zaghrini, D. Cacela, Z.-X. He, G. Letsou, G. Noon, J. F. Howell, et al. Relation of the Contractile Reserve of Hibernating Myocardium to Myocardial Structure in Humans Circulation, August 3, 1999; 100(5): 490 - 496. [Abstract] [Full Text] [PDF]
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F Fath-Ordoubadi, K J Beatt, N Spyrou, and P G Camici Efficacy of coronary angioplasty for the treatment of hibernating myocardium Heart, August 1, 1999; 82(2): 210 - 216. [Abstract] [Full Text] [PDF]
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J. J. Bax, D. Poldermans, A. Elhendy, J. H. Cornel, E. Boersma, R. Rambaldi, J. R. T. C. Roelandt, and P. M. Fioretti Improvement of left ventricular ejection fraction, heart failure symptoms and prognosis after revascularization in patients with chronic coronary artery disease and viable myocardium detected by dobutamine stress echocardiography J. Am. Coll. Cardiol., July 1, 1999; 34(1): 163 - 169. [Abstract] [Full Text] [PDF]
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M. A. Auerbach, H. Schoder, C. Hoh, S. S. Gambhir, S. Yaghoubi, J. W. Sayre, D. Silverman, M. E. Phelps, H. R. Schelbert, and J. Czernin Prevalence of Myocardial Viability as Detected by Positron Emission Tomography in Patients With Ischemic Cardiomyopathy Circulation, June 8, 1999; 99(22): 2921 - 2926. [Abstract] [Full Text] [PDF]
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F. Barilla, G. De Vincentis, E. Mangieri, M. Ciavolella, G. Pannitteri, F. Scopinaro, G. Critelli, and P. P. Campa Recovery of contractility of viable myocardium during inotropic stimulation is not dependent on an increase of myocardial blood flow in the absence of collateral filling J. Am. Coll. Cardiol., March 1, 1999; 33(3): 697 - 704. [Abstract] [Full Text] [PDF]
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S. C. Smart, P. N. Dionisopoulos, T. A. Knickelbine, T. Schuchard, and K. B. Sagar Dobutamine-atropine stress echocardiography for risk stratification in patients with chronic left ventricular dysfunction J. Am. Coll. Cardiol., February 1, 1999; 33(2): 512 - 521. [Abstract] [Full Text] [PDF]
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H. Acquatella, J. E. Perez, J. A. Condado, and I. Sanchez Limited myocardial contractile reserve and chronotropic incompetence in patients with chronic Chagas' disease: Assessment by dobutamine stress echocardiography J. Am. Coll. Cardiol., February 1, 1999; 33(2): 522 - 529. [Abstract] [Full Text] [PDF]
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H. Baumgartner, G. Porenta, Y.-K. Lau, M. Wutte, U. Klaar, M. Mehrabi, R. J. Siegel, J. Czernin, G.u. Laufer, H. Sochor, et al. Assessment of myocardial viability by dobutamine echocardiography, positron emission tomography and thallium-201 SPECT: Correlation with histopathology in explanted hearts J. Am. Coll. Cardiol., November 15, 1998; 32(6): 1701 - 1708. [Abstract] [Full Text] [PDF]
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M. G. Gunning, C. Anagnostopoulos, C. J. Knight, J. Pepper, E. D. Burman, G. Davies, K. M. Fox, D. J. Pennell, P. J. Ell, and S. R. Underwood Comparison of 201Tl, 99mTc-Tetrofosmin, and Dobutamine Magnetic Resonance Imaging for Identifying Hibernating Myocardium Circulation, November 3, 1998; 98(18): 1869 - 1874. [Abstract] [Full Text] [PDF]
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J. Meluzin, J. Cerny, M. Frelich, F. Stetka, L. Spinarova, J. Popelova, R. Stipal, and on behalf of the Investigators of This Multicenter Prognostic value of the amount of dysfunctional but viable myocardium in revascularized patients with coronary artery disease and left ventricular dysfunction J. Am. Coll. Cardiol., October 1, 1998; 32(4): 912 - 920. [Abstract] [Full Text] [PDF]
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I. Afridi, P. A. Grayburn, J. A. Panza, J. K. Oh, W. A. Zoghbi, and T. H. Marwick Myocardial viability during dobutamine echocardiography predicts survival in patients with coronary artery disease and severe left ventricular systolic dysfunction J. Am. Coll. Cardiol., October 1, 1998; 32(4): 921 - 926. [Abstract] [Full Text] [PDF]
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P. Steendijk, J. Baan Jr., E. T. Van Der Velde, and J. Baan Effects of critical coronary stenosis on global systolic left ventricular function quantified by pressure-volume relations during dobutamine stress in the canine heart J. Am. Coll. Cardiol., September 1, 1998; 32(3): 816 - 826. [Abstract] [Full Text] [PDF]
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S R Redwood, R Ferrari, and M S Marber Myocardial hibernation and stunning: from physiological principles to clinical practice Heart, September 1, 1998; 80(3): 218 - 222. [Full Text]
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 W. Wijns, S. F. Vatner, and P. G. Camici Hibernating Myocardium N. Engl. J. Med., July 16, 1998; 339(3): 173 - 181. [Full Text] [PDF]
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D Pagano, R S Bonser, J N Townend, F Ordoubadi, R Lorenzoni, and P G Camici Predictive value of dobutamine echocardiography and positron emission tomography in identifying hibernating myocardium in patients with postischaemic heart failure Heart, March 1, 1998; 79(3): 281 - 288. [Abstract] [Full Text]
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L. Ma, L. Chen, L. Gillam, D. D Waters, and C. Chen Nitroglycerin Enhances the Ability of Dobutamine Stress Echocardiography to Detect Hibernating Myocardium Circulation, December 2, 1997; 96(11): 3992 - 4001. [Abstract] [Full Text]
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Y. Genma, S. Ogawa, J. Zhang, and M. Yamamoto Evaluation of myocardial ischemia in Kawasaki disease by dobutamine stress signal-averaged ventricular late potentials Cardiovasc Res, December 1, 1997; 36(3): 323 - 329. [Abstract] [Full Text] [PDF]
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S. Ogawa, R. Fukazawa, T. Ohkubo, J. Zhang, N. Takechi, Y. Kuramochi, Y. Hino, O. Jimbo, Y. Katsube, M. Kamisago, et al. Silent Myocardial Ischemia in Kawasaki Disease : Evaluation of Percutaneous Transluminal Coronary Angioplasty by Dobutamine Stress Testing Circulation, November 18, 1997; 96(10): 3384 - 3389. [Abstract] [Full Text]
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M. F. Meza, S. Ramee, T. Collins, D. Stapleton, R. V. Milani, J. P. Murgo, and J. Cheirif Knowledge of Perfusion and Contractile Reserve Improves the Predictive Value of Recovery of Regional Myocardial Function Postrevascularization : A Study Using the Combination of Myocardial Contrast Echocardiography and Dobutamine Echocardiography Circulation, November 18, 1997; 96(10): 3459 - 3465. [Abstract] [Full Text]
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H. H. Lee, V. G. Davila-Roman, P. A. Ludbrook, M. Courtois, J. F. Walsh, D. A. Delano, P. J. Rubin, and R. J. Gropler Dependency of Contractile Reserve on Myocardial Blood Flow : Implications for the Assessment of Myocardial Viability With Dobutamine Stress Echocardiography Circulation, November 4, 1997; 96(9): 2884 - 2891. [Abstract] [Full Text]
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A. Elsasser, M. Schlepper, W.-P. Klovekorn, W.-j. Cai, R. Zimmermann, K.-D. Muller, R. Strasser, S. Kostin, C. Gagel, B. Munkel, et al. Hibernating Myocardium : An Incomplete Adaptation to Ischemia Circulation, November 4, 1997; 96(9): 2920 - 2931. [Abstract] [Full Text]
|
|
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A. Cohen, C. Chauvel, B. Benhalima, P. Guyon, I. Desert, J. Valty, and A. Cohen Is Dobutamine Stress Echocardiography Useful for Noninvasive Differentiation of Ischemic from Idiopathic Dilated Cardiomyopathy? Angiology, September 1, 1997; 48(9): 783 - 793. [Abstract] [PDF]
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G. von Degenfeld, W. Giehrl, and P. Boekstegers Targeting of dobutamine to ischemic myocardium without systemic effects by selective suction and pressure-regulated retroinfusion Cardiovasc Res, August 1, 1997; 35(2): 233 - 240. [Abstract] [Full Text] [PDF]
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J.-L. J. Vanoverschelde, W. Wijns, M. Borgers, G. Heyndrickx, C. Depre, W. Flameng, and J. A. Melin Chronic Myocardial Hibernation in Humans: From Bedside to Bench Circulation, April 1, 1997; 95(7): 1961 - 1971. [Full Text]
|
|
|
|
|
|
M. D. Cheitlin, J. S. Alpert, W. F. Armstrong, G. P. Aurigemma, G. A. Beller, F. Z. Bierman, T. W. Davidson, J. L. Davis, P. S. Douglas, L. D. Gillam, et al. ACC/AHA Guidelines for the Clinical Application of Echocardiography : A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography) Developed in Collaboration With the American Society of Echocardiography Circulation, March 18, 1997; 95(6): 1686 - 1744. [Full Text]
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|
|
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|
U. Qureshi, S. F. Nagueh, I. Afridi, P. Vaduganathan, A. Blaustein, M. S. Verani, W. L. Winters, and W. A. Zoghbi Dobutamine Echocardiography and Quantitative Rest-Redistribution 201Tl Tomography in Myocardial Hibernation: Relation of Contractile Reserve to 201Tl Uptake and Comparative Prediction of Recovery of Function Circulation, February 4, 1997; 95(3): 626 - 635. [Abstract] [Full Text]
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S. H. Rahimtoola Hibernating Myocardium Has Reduced Blood Flow at Rest That Increases With Low-Dose Dobutamine Circulation, December 15, 1996; 94(12): 3055 - 3061. [Full Text]
|
|
|
|
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R. O. Bonow Identification of Viable Myocardium Circulation, December 1, 1996; 94(11): 2674 - 2680. [Full Text]
|
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|
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|
C. R. deFilippi, D. L. Willett, W. N. Irani, E. J. Eichhorn, C. E. Velasco, and P. A. Grayburn Comparison of Myocardial Contrast Echocardiography and Low-Dose Dobutamine Stress Echocardiography in Predicting Recovery of Left Ventricular Function After Coronary Revascularization in Chronic Ischemic Heart Disease Circulation, November 15, 1995; 92(10): 2863 - 2868. [Abstract] [Full Text]
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 Finding Hibernating Myocardium with Dobutamine Echo Journal Watch Cardiology, April 1, 1995; 1995(401): 11 - 11. [Full Text]
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J. N. Oshinski, H.-C. Han, D. N. Ku, and R. I. Pettigrew Quantitative Prediction of Improvement in Cardiac Function after Revascularization with MR Imaging and Modeling: Initial Results Radiology, November 1, 2001; 221(2): 515 - 522. [Abstract] [Full Text] [PDF]
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K. M. Choi, R. J. Kim, G. Gubernikoff, J. D. Vargas, M. Parker, and R. M. Judd Transmural Extent of Acute Myocardial Infarction Predicts Long-Term Improvement in Contractile Function Circulation, September 4, 2001; 104(10): 1101 - 1107. [Abstract] [Full Text] [PDF]
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D. K. Kalra, X. Zhu, M. K. Ramchandani, G. Lawrie, M. J. Reardon, D. Lee-Jackson, W. L. Winters, N. Sivasubramanian, D. L. Mann, and W. A. Zoghbi Increased Myocardial Gene Expression of Tumor Necrosis Factor-{alpha} and Nitric Oxide Synthase-2: A Potential Mechanism for Depressed Myocardial Function in Hibernating Myocardium in Humans Circulation, April 2, 2002; 105(13): 1537 - 1540. [Abstract] [Full Text] [PDF]
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