Accuracy of currently available techniques for prediction of functional recovery after revascularization in patients with left ventricular dysfunction due to chronic coronary artery disease: comparison of pooled data. unfavorable predictive value than with a full protocol (47% 81%, p 0.001 and 65% 82%, p 0.05, respectively). The accuracy in the full protocol analysis was comparable with that reported in patients no longer taking blockers but was significantly lower than that in the low dose analysis (78% 66%, p 0.001). Conclusions: Findings suggest that blocker withdrawal is not necessary before DSE when viability is the clinical information in question. However, a completed protocol with continuous image recording is required to detect the full extent of viability. test was used for comparison of continuous variables. The sensitivity, specificity, and positive and negative predictive values of DSE for the detection of myocardial viability were calculated by using the recovery of resting segmental wall motion six months after CABG as the benchmark. The 2 2 test was used for comparison between proportions and the McNemar 2 test for comparison between paired proportions. A probability value of p 0.05 was considered significant. RESULTS Patient characteristics Eighteen patients (16 male, 2 female, mean (SD) age 62 (9) years) were enrolled in the study. Ejection fraction was 34 (7)%, range 17C40%. At least one previous myocardial infarction was documented in 15 of the patients. Fifteen patients were taking atenolol 50C100 mg daily, two were taking metoprolol 50 mg and 100 mg daily, and one was taking bisoprolol 10 mg daily. The patients’ medications were not discontinued for the study and, in addition to blockers, six patients were taking nitrates, five WJ460 were taking calcium channel blockers, seven were taking diuretics, and 14 were taking angiotensin converting enzyme inhibitors (table 1?1). Table 1 Clinical, angiographic, and operative data of study patients (n = 18) 56 of 78 (72%), p 0.1) (table 3?3). Table 3 Diagnostic accuracy of dobutamine echocardiography TLN2 in predicting recovery of resting function for akinetic and hypokinetic segments six months after revascularisation in patients taking blockers 34 of 72 (47%), p 0.001) and negative predictive value (65 of 79 WJ460 (82%) 70 of 108 (65%), p 0.05). Analysis of all DSE stages had a slightly worse specificity than low dose analysis (65 of 86 (76%) 70 of 86 (81%)) but this was not significant. The overall diagnostic accuracy of DSE to predict recovery of segmental wall motion six months after CABG was 78% (123 of 158) when the analysis considered all DSE stages and only 66% WJ460 (104 of 158) for the low dose analysis (p 0.001) (table 2?2). DISCUSSION We have shown in a clinical setting of chronic hibernation and oral blockade that, during DSE, WMSI in the presence of blockade improves maximally at the end of the 20 g/kg/min infusion and not at the traditionally used low dose stages. The sensitivity of WJ460 DSE to predict recovery of resting LV function after CABG is indeed low in patients taking blockers when analysis is based on the low dose protocol only. However, when analysis includes all infusion stages, DSE is usually both a sensitive and a specific predictor of the postoperative outcome of regional myocardial function in patients with ischaemic LV dysfunction who are taking blockers. Because of their unfavorable inotropic and chronotropic properties, blockers are.