Márcia Bueno Castier et al. José Raul Alves Carrinho Márcia Alves Carrinho Francisco Manes Albanesi Filho … Álvaro Villela de Moraes Fernando Portugal Morcerf
OBJECTIVE: To investigate a group of patients that have a significant lesion in a single-vessel and to demonstrate whether or not the sensitivity and specificity of a dobutamine stress echocardiography (DSE) was valuable in the evaluation of myocardial viability for these patients. METHODS: Twenty patients who had undergone percutaneous transluminal coronary angioplasty (PTCA) were studied. This group was evaluated 2 to 7 days (3.65 ± 1.69) before the procedure and 2 to 5 days (4 ± 0.80) after the procedure with a DSE. Myocardial viability was assessed three months after the procedure using a two dimensional echocardiogram. Twelve patients underwent PTCA on the left anterior descending artery (LAD), 7 on the right coronary artery (RC) and 1 on the circumflex artery (CX). Only one right coronary artery procedure was not 100% successful. RESULTS: From the 340 segments that were studied, 99 (29.18%) demonstrated contractile alterations of which 63 were hypokinetic (63.4%), 28 akinetic (28.28%) and 8 dyskinetic (8.08%). In reference to the segments involved, we obtained a sensitivity of 92.59%, specificity of 84.45%, and accuracy of 88.88% for the DSE. The solitary case of PTCA for the circumflex artery demonstrated 100% sensitivity. The LAD demonstrated a sensitivity of 88.58%, specificity of 95% and accuracy of 90.91%. For the RC segments, sensitivity was 91.30%, specificity 83.33% and accuracy 88.71%. All dyskinetic segments were unviable. The DSE predicted a 91.48% recovery rate for the 63 hypokinetic segments. CONCLUSION: The DSE is an effective test for evaluating myocardial viability in patients with a significant single-vessel disease.