Article (Scientific journals)
Significance of Dobutamine-Induced Changes in Qt Dispersion Early after Acute Myocardial Infarction
LANCELLOTTI, Patrizio; Bilge, A. R.; Mipinda, J. B. et al.
2001In American Journal of Cardiology, 88 (9), p. 939-43
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Abstract :
[en] This study sought to examine the effects of graded dobutamine infusion on QT dispersion early after acute myocardial infarction (AMI) and to investigate the relation of dobutamine-induced changes in QT dispersion to wall motion responses. Seventy-eight patients with a first AMI underwent dobutamine-atropine stress echocardiography 5 +/- 2 days after admission. Contractile reserve was identified in 45 patients and ischemic myocardium in 40. Sixteen patients had persistent akinesia. The best cut-off value of QT dispersion on the baseline electrocardiogram for predicting myocardial viability was 65 ms (sensitivity and specificity of 68%). Dobutamine infusion increased QT dispersion only in patients with viable myocardium (61 +/- 18 to 83 +/- 19 ms, p = 0.003) and/or ischemia (72 +/- 16 to 112 +/- 25 ms, p < 0.0001). No change was observed in patients with persistent akinesia (84 +/- 10 to 87 +/- 15 ms, p = NS). QT dispersion increased by 22 +/- 12 ms with administration of low-dose dobutamine in patients who had viable myocardium and by 47 +/- 21 ms with administration of low- to high-dose dobutamine in patients with ischemic myocardium. An increase in QT dispersion of > or = 20 ms from at rest to low-dose dobutamine infusion was associated with myocardial viability with a sensitivity of 78% and a specificity of 79%, whereas an increase in QT dispersion of > or = 10 ms from low- to high-dose dobutamine infusion predicted ischemic myocardium with a sensitivity of 85% and a specificity of 82%. In conclusion, (1) low QT dispersion on the baseline electrocardiogram is determined by the presence of viable myocardium, (2) a dobutamine-induced increase in QT dispersion is associated with viable and jeopardized myocardium, and (3) unchanged QT dispersion during dobutamine stress is a simple marker of extensive necrosis.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
LANCELLOTTI, Patrizio  ;  Centre Hospitalier Universitaire de Liège - CHU > Cardiologie
Bilge, A. R.
Mipinda, J. B.
PIERARD, Luc ;  Centre Hospitalier Universitaire de Liège - CHU > Service de cardiologie
Language :
English
Title :
Significance of Dobutamine-Induced Changes in Qt Dispersion Early after Acute Myocardial Infarction
Publication date :
01 November 2001
Journal title :
American Journal of Cardiology
ISSN :
0002-9149
eISSN :
1879-1913
Publisher :
Elsevier, New York, United States - New York
Volume :
88
Issue :
9
Pages :
939-43
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 26 June 2013

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