Prediction of short- and intermediate-term prognoses of patients with acute myocardial infarction using myocardial contrast echocardiography one day after recanalization

Abstract

The assessment of both the size of the initial RA and microvascular integrity on day 2 enables precise determination of the efficacy of reperfusion therapy and prediction of the short- and intermediate-term prognoses of patients with recanalized MI.

Impact of Microvascular Dysfunction on Left Ventricular Remodeling and Long-Term Clinical Outcome After Primary Coronary Angioplasty for Acute Myocardial Infarction

“…The importance of microvascular dysfunction by MCE complicating mechanical reperfusion after AMI as an additional major predictor of early LV remodeling has been suggested by recent studies. 5,6 The present study confirms and expands these preliminary observations in that microvascular dysfunction by MCE was shown to be an important and independent contributor to subsequent changes in LV geometry and performance. LV volumes were larger among patients with microvascular dysfunction than among patients without it beginning with the baseline (24-hour) echocardiographic examination and continued to increase throughout the study period.…”

“…5,6,20,21 Most of them studied very small AMI populations treated with different reperfusion strategies at different times and were focused mainly on inhospital or intermediate prognosis. Our prospective study provides information on the prognostic role of microvascular dysfunction by MCE in a quite homogeneous and unselected study population with AMI successfully treated by means of primary PTCA.…”

“…The link between microvascular dysfunction, as assessed by intracoronary myocardial contrast echocardiography (MCE), and unfavorable clinical outcome has been suggested by several studies. 5,6 However, the long-term prognosis after AMI, which is strongly related to progressive left ventricular (LV) dilation, remains unexplored in patients with microvascular dysfunction. Thus, we investigated the long-term prognostic impact of MCE microvascular dysfunction after successful primary percutaneous transluminal coronary angioplasty (PTCA) for AMI in terms of cardiac death and nonfatal events and LV function and remodeling in the surviving patients.…”

Clinical outcome and left ventricular remodeling in AMI patients with insufficient myocardial reperfusion after recanalization

“…[4][5][6][7] The link between microvascular dysfunction and unfavorable clinical outcome in real time and for short-and intermediate-term prognoses has been addressed by several studies. [8][9][10] The long-term prognosis after AMI, which is strongly related to progressive left ventricular (LV) remodeling, remains unexplored in patients with thrombolysis in myocardial infarction (TIMI) flow grade 3 and perfect angiographic results after recanalization. Thus, the present study was performed to (1) evaluate qualitative and quantitative MCE parameters in relation to functional recovery and LV remodeling and (2) assess the long-term prognostic impact of insufficient myocardial reperfusion after successful primary percutaneous coronary intervention (PCI) in the ST-segment elevation AMI-surviving patients with TIMI flow grade 3 and perfect angiographic results -corrected TIMI frame count (CTFC) <40.…”

Faktori rizika za kardiovaskularne bolesti i ishod reperfuzione terapije nakon infarkta miokarda sa ST elevacijom

“…Pojedine studije su pokazale da uspostavljanje TIMI 3 protoka u infarktom zahvaćenoj arteriji nije indikativan za uspješnu perfuziju miokarda [8]. Studije sa kontrastnom ehokardiografijom miokarda pokazuju da čak i u prisustvu normalnog epikardijalnog protoka nakon PPCI, umanjena miokardna perfuzija je udružena sa slabim oporavkom funkcije lijeve komore [6,9,10]. Rezolucija elevacije ST segmenta blisko koreliše sa nalazima kontrastne ehokardiografije [11].…”