This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Yetkin, E. Articles by Cehreli, S. Search for Related Content PubMed PubMed Citation Articles by Yetkin, E. Articles by Cehreli, S. Social Bookmarking                         What's this?

Identification of Viable Myocardium in Patients with Chronic Coronary Artery Disease and Myocardial Dysfunction: Comparison of Low-Dose Dobutamine Stress Echocardiography and Echocardiography During Glucose-Insulin-Potassium Infusion

Inonu University Faculty of Medicine, Department of Cardiology

Kubilay Senen

TYIH Department of Cardiology, Ankara, Turkey

Mehmet Ileri

TYIH Department of Cardiology, Ankara, Turkey

Ramazan Atak

TYIH Department of Cardiology, Ankara, Turkey

Bektas Battaoglu

Department of Cardiovascular Surgery, Malatya, Turkey

Ozkan Yetkin

Ankara University Faculty of Medicine, Department of Chest Disease, Ankara, Turkey

Izzet Tandogan

Inonu University Faculty of Medicine, Department of Cardiology

Hasan Turhan

TYIH Department of Cardiology, Ankara, Turkey

Sengül Cehreli

Inonu University Faculty of Medicine, Department of Cardiology

Low-dose dobutamine stress echocardiography (LDDSE) is one of the methods most used to assess myocardial viability. Glucose-insulin-potassium (GIK) has been shown to increase contraction of the ischemic zone. The aim of this study was to compare LDDSE and echocar diography during GIK infusion for detection of myocardial viability in patients with chronic coronary artery disease (CAD) and myocardial dysfunction. Twenty-one patients who had chronic CAD and myocardial dysfunction were included in the study. Glucose-insulin-potassium protocol consisted of a fixed dose of insulin (100 µU/kg/hour IV) and a variable glucose/potassium infusion rate. GIK echocardiography was made at baseline and after 60 minutes of GIK infusion. During continuous electrocardiographic, blood pressure, and echocar diographic monitoring, an intravenous infusion of dobutamine (3 µg/kg body weight/min) was started with an infusion pump and continued for 5 minutes and then increased to 5 µg/kg/min and 10 µg/kg/min for another 5 minutes. The detected viable myocardium was defined as 1 or 2 scores decreasing in at least 2 adjacent abnormal segments during LDDSE and GIK echocar diography. Viability was detected in 19% (52 segments) of the asynergic segments at baseline with GIK echocardiography and 16% (44 segments) of those segments with LDDSE (p > 0.05). Left ventricular wall motion score index at baseline was 2.24 ±0.35 and it decreased signifi cantly during both LDDSE (p = 0.004 vs 2.11 ±0.36) and GIK echocardiography (p=0.001 vs 2.09 ±0.32). The agreement between LDDSE and GIK echocardiography for detection of myocardial viability was 95%. This study shows that GIK echocardiography is similar to LDDSE for detection of myocardial viability. With the support of further clinical studies GIK echocar diography can be used to detect myocardial viability in patients with chronic CAD.

Angiology, Vol. 53, No. 6, 671-676 (2002)
DOI: 10.1177/000331970205300607


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?