{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T11:11:51Z","timestamp":1775560311228,"version":"3.50.1"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1995,6]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            Although both\n            <jats:sup>201<\/jats:sup>\n            Tl scintigraphy and low-dose dobutamine echocardiography (LDDE) have been proposed as effective methods of assessing myocardial viability, their relative efficacies are unknown. The aim of the present study was to compare the two imaging techniques in the prediction of improvement of regional left ventricular (LV) function after surgical revascularization.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            Thirty-eight patients with severe chronic LV dysfunction (ejection fraction \u226440%, one or more akinetic [Ak] or severely hypokinetic [SH] segments on resting echocardiogram) who underwent uncomplicated coronary artery bypass graft surgery were studied with simultaneous dobutamine stress echocardiography and poststress reinjection\n            <jats:sup>201<\/jats:sup>\n            Tl single-photon emission computed tomography (SPECT) before surgery. The Ak or SH segments were considered viable by LDDE when wall thickening improved during the infusion of 10 \u03bcg \u00b7 kg\n            <jats:sup>\u22121<\/jats:sup>\n            \u00b7 min\n            <jats:sup>\u22121<\/jats:sup>\n            dobutamine. Scintigraphic definition of viability was the presence of normal\n            <jats:sup>201<\/jats:sup>\n            Tl uptake, totally reversible defect, partially reversible defect, or moderately severe fixed defect. The postoperative improvement of dyssynergic segments was determined with a rest echocardiogram 3 months after surgery. Of 608 LV segments, 169 were classified as Ak and 51 as SH on resting preoperative echocardiography. Of these, 170 were successfully revascularized. Wall motion during LDDE improved in 33 severely dyssynergic segments and was more frequent in SH than in Ak segments (19 of 44 versus 14 of 126,\n            <jats:italic>P<\/jats:italic>\n            &lt;.0001). Viability was detected by\n            <jats:sup>201<\/jats:sup>\n            Tl SPECT criteria in 103 SH or Ak segments. Thirty-two of the 33 segments from LDDE responders were judged viable on\n            <jats:sup>201<\/jats:sup>\n            Tl SPECT, whereas\n            <jats:sup>201<\/jats:sup>\n            Tl viability was also detected in 71 of 137 segments from LDDE nonresponders. The sensitivity and the specificity for the prediction of postoperative improvement of segmental wall motion were 74% (95% confidence interval [CI], 67% to 81%) and 95% (95% CI, 92% to 98%) by LDDE and 89% (95% CI, 84% to 94%) and 48% (95% 40% to 56%) by\n            <jats:sup>201<\/jats:sup>\n            Tl SPECT, respectively. Positive predictive value of LDDE was higher than that of\n            <jats:sup>201<\/jats:sup>\n            Tl SPECT (85%, [95% CI, 80% to 90%] versus 33% [95% CI, 26% to 40%]). Thirty-six patients had angina before and only 1 had angina 3 months after revascularization. High-dose dobutamine echocardiography demonstrated significant reduction in stress-induced ischemia (new or worsening of preexisting wall motion abnormalities) after surgery (from 163 to 23 LV segments).\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            In patients with severe chronic LV dysfunction, LDDE is a good predictor of the improvement of dyssynergic segments after revascularization. Because\n            <jats:sup>201<\/jats:sup>\n            Tl SPECT overestimates the probability of postoperative improvement of dyssynergic segments, LDDE should be the preferred imaging technique for preoperative assessment of these patients.\n          <\/jats:p>","DOI":"10.1161\/01.cir.91.11.2748","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:34:42Z","timestamp":1339461282000},"page":"2748-2752","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":246,"title":["Prediction of Improvement of Regional Left Ventricular Function After Surgical Revascularization"],"prefix":"10.1161","volume":"91","author":[{"given":"Mariarosaria","family":"Arnese","sequence":"first","affiliation":[{"name":"From the Thoraxcenter, Departments of Cardiology (M.A., J.H.C., A.S., A.E., F.J.T.C., D.K., A.H.M.M.B., J.R.T.C.R., P.M.F.) and Cardiac Surgery (A.P.W.M.M.) and the Department of Nuclear Medicine (A.E.M.R.), University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan H.","family":"Cornel","sequence":"additional","affiliation":[{"name":"From the Thoraxcenter, Departments of Cardiology (M.A., J.H.C., A.S., A.E., F.J.T.C., D.K., A.H.M.M.B., J.R.T.C.R., P.M.F.) and Cardiac Surgery (A.P.W.M.M.) and the Department of Nuclear Medicine (A.E.M.R.), University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Salustri","sequence":"additional","affiliation":[{"name":"From the Thoraxcenter, Departments of Cardiology (M.A., J.H.C., A.S., A.E., F.J.T.C., D.K., A.H.M.M.B., J.R.T.C.R., P.M.F.) and Cardiac Surgery (A.P.W.M.M.) and the Department of Nuclear Medicine (A.E.M.R.), University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander P.W.M.","family":"Maat","sequence":"additional","affiliation":[{"name":"From the Thoraxcenter, Departments of Cardiology (M.A., J.H.C., A.S., A.E., F.J.T.C., D.K., A.H.M.M.B., J.R.T.C.R., P.M.F.) and Cardiac Surgery (A.P.W.M.M.) and the Department of Nuclear Medicine (A.E.M.R.), University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdou","family":"Elhendy","sequence":"additional","affiliation":[{"name":"From the Thoraxcenter, Departments of Cardiology (M.A., J.H.C., A.S., A.E., F.J.T.C., D.K., A.H.M.M.B., J.R.T.C.R., P.M.F.) and Cardiac Surgery (A.P.W.M.M.) and the Department of Nuclear Medicine (A.E.M.R.), University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambroos E.M.","family":"Reijs","sequence":"additional","affiliation":[{"name":"From the Thoraxcenter, Departments of Cardiology (M.A., J.H.C., A.S., A.E., F.J.T.C., D.K., A.H.M.M.B., J.R.T.C.R., P.M.F.) and Cardiac Surgery (A.P.W.M.M.) and the Department of Nuclear Medicine (A.E.M.R.), University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Folkert J.","family":"Ten Cate","sequence":"additional","affiliation":[{"name":"From the Thoraxcenter, Departments of Cardiology (M.A., J.H.C., A.S., A.E., F.J.T.C., D.K., A.H.M.M.B., J.R.T.C.R., P.M.F.) and Cardiac Surgery (A.P.W.M.M.) and the Department of Nuclear Medicine (A.E.M.R.), University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Keane","sequence":"additional","affiliation":[{"name":"From the Thoraxcenter, Departments of Cardiology (M.A., J.H.C., A.S., A.E., F.J.T.C., D.K., A.H.M.M.B., J.R.T.C.R., P.M.F.) and Cardiac Surgery (A.P.W.M.M.) and the Department of Nuclear Medicine (A.E.M.R.), University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aggie H.M.M.","family":"Balk","sequence":"additional","affiliation":[{"name":"From the Thoraxcenter, Departments of Cardiology (M.A., J.H.C., A.S., A.E., F.J.T.C., D.K., A.H.M.M.B., J.R.T.C.R., P.M.F.) and Cardiac Surgery (A.P.W.M.M.) and the Department of Nuclear Medicine (A.E.M.R.), University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos R.T.C.","family":"Roelandt","sequence":"additional","affiliation":[{"name":"From the Thoraxcenter, Departments of Cardiology (M.A., J.H.C., A.S., A.E., F.J.T.C., D.K., A.H.M.M.B., J.R.T.C.R., P.M.F.) and Cardiac Surgery (A.P.W.M.M.) and the Department of Nuclear Medicine (A.E.M.R.), University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo M.","family":"Fioretti","sequence":"additional","affiliation":[{"name":"From the Thoraxcenter, Departments of Cardiology (M.A., J.H.C., A.S., A.E., F.J.T.C., D.K., A.H.M.M.B., J.R.T.C.R., P.M.F.) and Cardiac Surgery (A.P.W.M.M.) and the Department of Nuclear Medicine (A.E.M.R.), University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90551-B"},{"key":"e_1_3_2_2_2","first-page":"815","volume":"33","year":"1992","unstructured":"Bonow RO, Dilsizian V. 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Herz. 1994;19:19-27.","journal-title":"Herz"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(91)90040-R"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90373-9"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(05)80308-4"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.90.3.8087956"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)90545-A"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.91.11.2748","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T15:31:39Z","timestamp":1715527899000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.91.11.2748"}},"subtitle":["A Comparison of Low-Dose Dobutamine Echocardiography With\n            <sup>201<\/sup>\n            Tl Single-Photon Emission Computed Tomography"],"short-title":[],"issued":{"date-parts":[[1995,6]]},"references-count":19,"journal-issue":{"issue":"11","published-print":{"date-parts":[[1995,6]]}},"alternative-id":["10.1161\/01.CIR.91.11.2748"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.91.11.2748","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,6]]},"assertion":[{"value":"1994-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1994-12-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1995-06-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}