Detection of Residual Ischemia Soon After Myocardial Infarction by Dobutamine Stress Testing

Dobutamine stress testing (DTS) and submaximal exercise testing (ET) were undertaken to induce residual ischemia in 52 patients in the second week after acute myocardial infarction (AMI). Both tests were limited by a heart rate of 120/min and were accepted positive when horizontal or down-sloping or up-sloping Ionger than 0.08 sec ST segment depression?1 mm was seen. Forty patients had undergone coronary angiopraphy 3-6 months after AMI. Heart rate and double product increased significantly during both tests. DST was positive in 21 (40 %) and ET in 16 (31 %) patients. The concordance between the two tests was 63 percent. There was no significant difference with DST in the rate of positivity between 19 patients with one-vessel disease and 21 patients with two or three-vessel disease. and also between the anterior and the inferior AMIs. DST was stopped before 20 ug/kg/min in 20 patients for the following reasons: significant ST depression in eight, systolic blood pressure > 200 mmHg in four, sinus tachycardia in five, frequent ventricular extrasystoles in one and chest pain in two. In conclusion, DST can be easily used in the second week after AMI without any serious complications. Its sensitivity to induce residual ischemia is high.