Left ventricular remodeling can be predicted with left ventricular volume response during dobutamine echocardiography after acute myocardial infarction

Objectives: This study was performed to evaluate the significance of left ventricular (LV) volume response during dobutamine stress echocardiography (DSE) in the prediction of LV volume change during follow-up (F/U) in patients with acute myocardial infarction (AMI). Methods: Forty-five patients with AMI (male 39, age 57±10 y, anterior myocardial infarction [MI] 29) underwent DSE 6±4 d after AMI. Revascularization of the infarct-related artery was performed if severe stenosis was present, A F/U echocardiography was performed 7.5±3.4 mo after DSE. The LV end-diastolic volume (EDV) and end-systolic volume (ESV) using the modified Simpson's method were measured at baseline echocardiography, low-dose (10 μg x kg^-1 x min^-1) DSE, and F/U echocardiography. Results: Patients were divided into 2 groups; Group I (n = 21) with an abnormal response (<10% decrease) in LVEDV during low-dose DSE; Group II (n = 24) with a normal response (≥10% decrease) in LVEDV during low-dose DSE. At F/U echocardiography, the (%) change of LVEDV was significantly different between the 2 groups (-2.0±16.7 versus -22.6±24.7%, p<0.01). Using multivariate analysis, the response of LVEDV (%) at low-dose DSE was the only significant independent predictor of the change of LVEDV (%) during F/U (y = 0.85 x = 0.08, r = 0.63, p<0.001). Conclusions: The response of LVEDV during DSE can be used as a predictor for the LV volume change after AMI.