Compared Adenosine Stress Echocardiography With Dobutamine Stress Echocardiography In Diagaosis Of Hibernating Myocardium

Objective: To compare the diagnostic value of adenosine stress echocardiography(ASE) with dobutamine stress echocardiography(DSE) in hibernating myocardium. Methods: In control group, open chest without ligating left anterior descending coronary artery in 10 rabbits. In model group, systolic dysfunction of regional myocardium was produced by making astenosis of left anterior descending coronary artery(≥50%) in 28 rabbits. Adenosine stress echocardiography and dobutamine stress echocardiography were performed for all the rabbits after 30 days. Stored the images in the hard ware, measured the peak sustained systolic strain rate (SRs) and the peak systolic tissue velocity (Vs) of those. Compared the results with angiocardiography, and the hibernating myocardium was observed under microscope. Results: SRs and Vs of normal myocardium enhanced by the increase of dose of dobutamine(P<0.05). In model group, SRs and Vs enhanced on the first states of baseline,5,10 and 20 ug·kg-1·min-1,and no obviously enhanced on 30 ug·kg-1·min-1,and began to decrease on 40 ug·kg-1·min-1 (P<0.05). SRs and Vs of normal myocardium were not obviously enhanced by the increase of dose of adenosine (P>0.05). In model group, SRs and Vs enhanced on the first states of baseline and 80 ug·kg-1·min-1,and no obviously enhance on 100 ug·kg-1·min-1,and began to decrease on 110 ug·kg-1·min-1 (P<0.05).The sensitivity of detecting hibernating myocardium by strain rate imaging during dobutamine stress echocardiography was 90.9% and the specificity was 66.7%. The sensitivity of tissue velocity imaging during dobutamine stress echocardiography was 95.5% and the specificity was 50%. The sensitivity of detecting hibernating myocardium by strain rate imaging during adenosine stress echocardiography was 81.8% and the specificity was 83.3%. The sensitivity of tissue velocity imaging during adenosine stress echocardiography was 86.4% and the specificity was 66.7%. Conclution: The sensitivity of dobutamine stress echocardiography in detecting hibernating myocardium was higher than adenosine stress echocardiography and the specificity was lower than adenosine stress echocardiography. The sensitivity of tissue velocity imaging in detecting hibernating myocardium was higher than strain rate imaging and the specificity was lower than strain rate imaging.