Comparison of Dobutamine Echocardiography, Dobutamine Sestamibi, and Rest-Redistribution Thallium-201 Single-Photon Emission Computed Tomography for Determining Contractile Reserve and Myocardial Ischemia in Ischemic Cardiomyopathy

Abstract Both dobutamine stress echocardiography (DSE) and myocardial perfusion scintigraphy are used to assess myocardial viability. Few studies have compared the data on myocardial viability and ischemia by low and peak dose DSE and myocardial perfusion imaging in the same patients. Fifty-four patients (45 men and 9 women aged 65 ± 9 years) with ischemic cardiomyopathy (mean ejection fraction 24 ± 9%) underwent rest 4-hour redistribution thallium-201 single-photon emission computed tomography (SPECT), low and peak dose DSE, and dobutamine sestamibi SPECT. A total of 864 segments were analyzed (16 segments/patient). Wall motion abnormality was present in 796 segments (92%), and contractile reserve during dobutamine infusion was seen in 400 of these segments (50%). Contractile reserve was seen in 331 of 509 hypokinetic segments (65%) and 69 of 287 akinetic/dyskinetic segments (24%) (p