Combined assessment of microvascular integrity and contractile reserve improves differentiation of stunning and necrosis after acute anterior wall myocardial infarction

Main, Michael L.; Magalski, Anthony; Morris, Becky A.; Coen, Michael M; Skolnick, David G.; Good, Thomas H.

doi:10.1016/s0735-1097(02)02124-1

Cited by 35 publications

(20 citation statements)

References 23 publications

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“…Recently, several studies have shown that myocardial contrast echocardiography (MCE) enables assessment of myocardial perfusion and has the potential to predict recovery of function in patients shortly after acute myocardial infarction (AMI) [4][5][6][7][8][9][10][11]. However, there are still a few data about the accuracy of MCE in predicting hibernating myocardium.…”

mentioning

confidence: 99%

Identification of hibernating myocardium with myocardial contrast echocardiography

Toušek

Pěnička

Tintěra

et al. 2008

International Journal of Cardiology

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mentioning

confidence: 99%

Identification of hibernating myocardium with myocardial contrast echocardiography

Toušek

Pěnička

Tintěra

et al. 2008

International Journal of Cardiology

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“…MCE performed before hospital discharge has thus been shown to: accurately differentiate 'stunning' from necrosis [18,29,34]; delineate transmural extent of infarction [16 ]; predict the recovery of regional and global left ventricular systolic function in the recuperative phase [16 ,18,21,29,30,34,36]; identify patients at high risk of Contrast echocardiography in myocardial viability Hayat and Senior 475 left ventricular remodelling [22,23 ,37], and also provide incremental viability data when performed in conjunction with the clinical reference standard, low-dose dobutamine echocardiography [38].…”

Section: After Acute Myocardial Infarctionmentioning

confidence: 99%

Contrast echocardiography for the assessment of myocardial viability

Hayat

Senior²

2006

Current Opinion in Cardiology

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“…Previous studies showed that MCE is also useful for predicting functional recovery and LV dilatation after AMI. [11][12][13][14] Although these two echocardiographic modalities are well established, differences between them have not been fully elucidated. Thus, the purpose of this study was to assess the role of MCE compared with LDSE in predicting functional recovery and regional as well as global LV remodelling in patients with successful revascularisation after AMI.…”

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confidence: 99%

Intravenous myocardial contrast echocardiography predicts regional and global left ventricular remodelling after acute myocardial infarction: comparison with low dose dobutamine stress echocardiography

Abe

2005

Heart

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Objective: To assess the role of intravenous myocardial contrast echocardiography (MCE) in predicting functional recovery and regional or global left ventricular (LV) remodelling after acute myocardial infarction (AMI) compared with low dose dobutamine stress echocardiography (LDSE). Methods: 21 patients with anterior AMI and successful primary angioplasty underwent MCE and LDSE during the subacute stage (2-4 weeks after AMI). Myocardial perfusion and contractile reserve were assessed in each segment (12 segment model) with MCE and LDSE. The 118 dyssynergic segments in the subacute stage were classified as recovered, unchanged, or remodelled according to wall motion at six months' follow up. Percentage increase in LV end diastolic volume (%DEDV) was also calculated. Results: The presence of perfusion was less accurate than the presence of contractile reserve in predicting regional recovery (55% v 81%, p , 0.0001). However, the absence of perfusion was more accurate than the absence of contractile reserve in predicting regional remodelling (83% v 48%, p , 0.0001). The number of segments without perfusion was an independent predictor of %DEDV, whereas the number of segments without contractile reserve was not. The area under the receiver operating characteristic curve showed that the number of segments without perfusion predicted substantial LV dilatation (%DEDV . 20%) more accurately than did the number of segments without contractile reserve (0.88 v 0.72). Conclusion: In successfully revascularised patients with AMI, myocardial perfusion assessed by MCE is predictive of regional and global LV remodelling rather than of functional recovery, whereas contractile reserve assessed by LDSE is predictive of functional recovery rather than of LV remodelling.A cute myocardial infarction (AMI) results in regional left ventricular (LV) dysfunction as a result of necrosis or myocardial stunning.

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Combined assessment of microvascular integrity and contractile reserve improves differentiation of stunning and necrosis after acute anterior wall myocardial infarction

Abstract: Myocardial contrast echocardiography compares favorably with LDDE in predicting recovery of regional LV dysfunction after acute anterior wall MI. Concordant contractile reserve and myocardial perfusion results further enhance the diagnostic accuracy.

Cited by 35 publications

References 23 publications

Identification of hibernating myocardium with myocardial contrast echocardiography

Identification of hibernating myocardium with myocardial contrast echocardiography

Contrast echocardiography for the assessment of myocardial viability

Intravenous myocardial contrast echocardiography predicts regional and global left ventricular remodelling after acute myocardial infarction: comparison with low dose dobutamine stress echocardiography

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