I wonder what kind of echo stress contributes most to the diagnosis of myocardial viability, and if the addition of the strain can add value to the method.
I wonder to assess myocardial viability if it is better to use low-dose dobutamine or dipyridamole and whether and how the strain adds to the diagnosis
We have good experience with low dose DSE. Stress testing is more about how much your eyes are tuned into looking at viability rather than strain imaging.
I'm assuming by 'strain' you're referring to 2D or 3D speckle-tracking? I'm not sure Tissue Doppler imaging adds much to the assessment (indeed there is published data to support that the incremental benefit is negligable).
Dipyridamole, as a vasodilator, is more useful for perfusion imaging rather than wall motion assessment and in this context is used with microsphere contrast, which is likely to render your strain software useless... While perfusion imaging has been described as a measure of viability, i am less certain of the proven value of Dipyridamole and wall motion assessment in this context.
On the other hand, Dobutamine is well established for viability assessment and can easily provide a measureable substrate for strain imaging. However, in our lab as with many others, this again is used frequently with contrast to improve endocardial definition which unfortunately renders most strain software uselss...
If it were feasible i can certainly see a value for it in patients with very severe systolic dysfunction where improvement may be quite subtle indeed.
- Badges
- Science topic
- Similar topics
- Biological Science
- Immunology
- Antibodies