1151-145 Accuracy of strain rate techniques for identification of viability at dobutamine stress echo: A follow-up study after revascularization

Abstract

Background. Myocardial viability (VM) assessment based on wall motion scoring (WMS) with dobutamine echo (DbE) is difficult and subjective. New quantitative techniques such as strain rate imaging (SRI) correspond with isotopic techniques but their ability to predict functional recovery (FR) after revascularization is unclear. Methods. Stable post-MI pts (n=43, age 63±9, EF 36±6%) underwent SRI during DbE. WMS evidence of VM was based on lowdose augmentation at DbE. SR, end-systolic strain (ESS), post-systolic strain (PSS) and timing were analyzed at rest and low dose in abnormal segts. Pts were followed for 9±12 months; FR was defined as segt improvement on post-revascularization images. Results: Of 180 segts with abnormal resting function, 83 showed FR and 97 did not. Resting parameters were not predictive of recovery; resting post-systolic shortening had a sensitivity and specificity 0.6), SR increment (0.5±0.5 vs 0.1±0.6/s, p 0.23), ESS (11.6±9.2 vs 4.7±9.3, p 8.5), ESS increment (4.9±9.9 vs 0.7±6.2, p 3.4) and time to ES (0.31±0.9 vs 0.38±0.09, p<0.001, cutoff <0.32). Sensitivity and specificity of quantitative parameters were comparable to WM analysis (Table). Conclusions. SR and strain responses to DbE are a feasible marker of viability, comparable to WM assessment.