The pathophysiologic basis for the use of dobutamine echocardiography for the assessment of myocardial viability

Using clinical and electrocardiographic information alone, it is often difficult to determine whether dysfunctional myocardial segments are viable. Based on its ability to elicit contractile reserve, dobutamine has been found to be useful in assessing the presence or absence of viability in these segments. Imaging with two-dimensional echocardiography at rest and during different doses of dobutamine is currently used as a diagnostic tool for assessing viability both after acute myocardial infarction and in the context of chronic coronary artery disease. This review will discuss the pathophysiologic basis for the use of dobutamine echocardiography in these clinical settings.