Assessment of myocardial viability using early systolic mitral annular motion velocities responses to dobutamine infusion in patients with previous myocardial infarction

Background Dobutamine stress echocardiography (DSE) is widely used for detection of myocardial viability. The main limitation of DSE is its subjective interpretation. Assessment of mitral annular motion velocities with tissue Doppler imaging is simple and quantitative measurement. Objective It is to determine the relationship between myocardial viability and regional systolic mitral annular motion velocity response to dobutamine stress in patients with previous myocardial infarction with pulsed tissue Doppler imaging (TDI). Methods Our study group included 101 patients with previous myocardial infarction. All the patients underwent conventional DSE and dobutamine stress tissue Doppler echocardiography (DSTDE) measuring velocities of presystolic wave (SW1) and peak systolic wave (SW2) at rest and during low-dose dobutamine infusion. Results After exclusion of the normokinetic walls, we analyzed 505 walls.( Table 1 ) Using the conventional DSE as the gold standard for detection of myocardial viability, the sensitivity of the DSTDE using SW1 for detection of viability was 94.8% and its specificity was 91.7%, while the sensitivity using SW2 for detection of viability was 87.8%, and its specificity was 81.5%. Conclusion The presystolic wave during DSTDE showed a greater sensitivity and specificity for the prediction of myocardial viability than the systolic wave.