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Figure 6 Resting and Dobutamine Stress Echo for Myocardial Thinning, CR, and Myocardial Ischemia

Integration of resting data and new technologies predicts functional recovery in a patient with severe dysfunction (LVEF 25%). The resting study (A) shows no areas of thinning (1-cm markers in all walls) despite severe LV dysfunction and borderline restrictive filling (DT: 150 ms, E/A >2). Dobutamine stress shows basal inferior ischemia and mid inferior biphasic response in B. Peak-dose (40 µg/kg/min) dobutamine response showed hypokinetic septal and lateral walls had deteriorated at peak dose, which is consistent with extensive ischemia (C). CR = contractile reserve; DT = deceleration time; E/A = early-to-late diastolic filling ratio; HR = heart rate; other abbreviations as in Figure 2.