Detection of TIMI-3 Flow Before Mechanical Reperfusion With Ultrasonic Tissue Characterization in Patients With Anterior Wall Acute Myocardial Infarction

Abstract

Background-Spontaneous coronary reperfusion with TIMI-3 flow is associated with favorable clinical outcomes in patients with acute myocardial infarction (AMI). We investigated the ability of analyzing cardiac cycle-dependent variation of myocardial integrated backscatter (IBS) for predicting spontaneous reperfusion in anterior AMI. Methods and Results-We recorded IBS images on admission in 104 patients with first anterior wall AMI and subsequently performed coronary angiography and coronary intervention. We measured the cyclic variation of IBS within the infarct zone and expressed its magnitude as phase-corrected magnitude (PCM) by giving positive and negative values when it showed synchronous and asynchronous contraction, respectively.

Caracterização tecidual ultra-sônica em síndromes coronarianas agudas

“…Scar delimitation with deposition of collagen requires a time period longer than four weeks of delay between the onset of symptoms and assessment. Since inclusion criteria in the present study required the absence of previous ischemic events or of any other factors that would involve myocardial structural damage -such as diabetes mellitus -nondifferentiation between the groups was not unexpected, and is in agreement with studies published elsewhere [8][9][10][15][16][17] . IBS variation amplitude changes are reported much earlier, and are more easily subject to documentation due to their ultrasonic tissue characterization.…”

“…In addition to IBS variability, changes in pattern or delay are documented and considered more sensitive, and stand as a possibility for the purpose of predicting the viability of injured myocardial tissue 9,10,12,[15][16][17][18][19][20][21] . Such phenomenon has been investigated through techniques that are not available in the equipment used in the present study.…”

“…The analysis of synchronicity parameters (delay index and pattern) has been attractive from its potential to identify myocardial viability 9,10,12,[15][16][17][18][19][20][21] . In the present study such analysis was limited to echocardiographic assessment of ventricular segmental motility recovery at rest.…”

Non-Invasive Quantitation of Myocardial Fibrosis Using Combined Tissue Harmonic Imaging and Integrated Backscatter Analysis in Dilated Cardiomyopathy

“…In previous reports about IB several parameters were proposed [7,12,13,14,15,16,17,18,19]. In this study, we measured 2 parameters, m-IB and CV-IB, because these parameters are easy to measure and have good reproducibility and objectivity, which are very important in clinical setting.…”

“…Four cut-off values of m-IB with THI had high sensitivity, specificity, and accuracy for discrimination of each level of myocardial fibrosis severity. Previously the usefulness of IB for tissue characterization has been discussed in many studies [7,8,9,14,15,16,17,18,19, 22], but we first documented cut-off values of IB for the quantification of myocardial fibrosis in DCM. We think that combined m-IB and THI is much useful compared with IB alone and is practically acceptable method in evaluation of severity of myocardial fibrosis in clinical settings.…”