Noninvasive Differentiation of Ischemic Cardiomyopathy From Idiopathic Dilated Cardiomyopathy With Ultrasonic Tissue Characterization Using Integrated Backscatter

Hiroshi Itoh, Katsuomi Iwakura, Atsunori Okamura, Koichi Inoue, Shigeo Kawano, Kenshi Fujii

Research output: Contribution to journalArticle

Abstract

Background. The aim of this study was to discriminate ischemic cardiomyopathy (ICM) from dilated cardiomyopathy (DCM) based on inter-segmental and transmural differences in ultrasonic tissue characters. Methods. The study population consisted of 40 patients with DCM and 40 patients with ICM with ejection fraction of <40%. We recorded short-axis integrated backscatter (IBS) images in each patient. We measured the absolute differences in average IBS values between the anterior septum and posterior wall (|A-P|, dB). We also measured the difference of average IBS in the inner layer minus that in the outer layer in either anterior septum or posterior wall that was more dysfunctional (In-Out, dB). Results. |A-P| was significantly higher in ICM than DCM (5.3±1.7 vs. 2.7±1.4, p<0.001). Receiver-operating characteristic analysis demonstrated that we can differentiate ICM from DCM with sensitivity of 80 % and specificity of 73 % using |A-P| > 4 dB as a cut-off point. (In-Out) was also significantly higher in ICM than DCM (1.6±1.4 vs. -0.9± 1.9, p<0.001). We can also differentiate ICM from DCM with sensitivity of 93 % and specificity of 70 % using (In-Out) >0 dB as a cut-off point. Additionally, all patients with |A-P| > 3 dB and (In-Out) >0 dB belonged to the ICM group except for one patient. Conclusions. Inter-segmental and transmural differences in myocardial IBS are significantly greater in the ICM than in DCM. Using these particular ultrasonic tissue characters, we can discriminate ICM from DCM with favorable sensitivity and specificity.

Original languageEnglish
Pages (from-to)33-39
Number of pages7
JournalJournal of Echocardiography
Volume3
Issue number1
DOIs
Publication statusPublished - 2005
Externally publishedYes

Fingerprint

Dilated Cardiomyopathy
Cardiomyopathies
Ultrasonics
Sensitivity and Specificity
Population

Keywords

  • Cardiomyopathy
  • Cntractility
  • Echocardiography
  • Heart failure
  • Myocardial infarction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Noninvasive Differentiation of Ischemic Cardiomyopathy From Idiopathic Dilated Cardiomyopathy With Ultrasonic Tissue Characterization Using Integrated Backscatter. / Itoh, Hiroshi; Iwakura, Katsuomi; Okamura, Atsunori; Inoue, Koichi; Kawano, Shigeo; Fujii, Kenshi.

In: Journal of Echocardiography, Vol. 3, No. 1, 2005, p. 33-39.

Research output: Contribution to journalArticle

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abstract = "Background. The aim of this study was to discriminate ischemic cardiomyopathy (ICM) from dilated cardiomyopathy (DCM) based on inter-segmental and transmural differences in ultrasonic tissue characters. Methods. The study population consisted of 40 patients with DCM and 40 patients with ICM with ejection fraction of <40{\%}. We recorded short-axis integrated backscatter (IBS) images in each patient. We measured the absolute differences in average IBS values between the anterior septum and posterior wall (|A-P|, dB). We also measured the difference of average IBS in the inner layer minus that in the outer layer in either anterior septum or posterior wall that was more dysfunctional (In-Out, dB). Results. |A-P| was significantly higher in ICM than DCM (5.3±1.7 vs. 2.7±1.4, p<0.001). Receiver-operating characteristic analysis demonstrated that we can differentiate ICM from DCM with sensitivity of 80 {\%} and specificity of 73 {\%} using |A-P| > 4 dB as a cut-off point. (In-Out) was also significantly higher in ICM than DCM (1.6±1.4 vs. -0.9± 1.9, p<0.001). We can also differentiate ICM from DCM with sensitivity of 93 {\%} and specificity of 70 {\%} using (In-Out) >0 dB as a cut-off point. Additionally, all patients with |A-P| > 3 dB and (In-Out) >0 dB belonged to the ICM group except for one patient. Conclusions. Inter-segmental and transmural differences in myocardial IBS are significantly greater in the ICM than in DCM. Using these particular ultrasonic tissue characters, we can discriminate ICM from DCM with favorable sensitivity and specificity.",
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AB - Background. The aim of this study was to discriminate ischemic cardiomyopathy (ICM) from dilated cardiomyopathy (DCM) based on inter-segmental and transmural differences in ultrasonic tissue characters. Methods. The study population consisted of 40 patients with DCM and 40 patients with ICM with ejection fraction of <40%. We recorded short-axis integrated backscatter (IBS) images in each patient. We measured the absolute differences in average IBS values between the anterior septum and posterior wall (|A-P|, dB). We also measured the difference of average IBS in the inner layer minus that in the outer layer in either anterior septum or posterior wall that was more dysfunctional (In-Out, dB). Results. |A-P| was significantly higher in ICM than DCM (5.3±1.7 vs. 2.7±1.4, p<0.001). Receiver-operating characteristic analysis demonstrated that we can differentiate ICM from DCM with sensitivity of 80 % and specificity of 73 % using |A-P| > 4 dB as a cut-off point. (In-Out) was also significantly higher in ICM than DCM (1.6±1.4 vs. -0.9± 1.9, p<0.001). We can also differentiate ICM from DCM with sensitivity of 93 % and specificity of 70 % using (In-Out) >0 dB as a cut-off point. Additionally, all patients with |A-P| > 3 dB and (In-Out) >0 dB belonged to the ICM group except for one patient. Conclusions. Inter-segmental and transmural differences in myocardial IBS are significantly greater in the ICM than in DCM. Using these particular ultrasonic tissue characters, we can discriminate ICM from DCM with favorable sensitivity and specificity.

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KW - Cntractility

KW - Echocardiography

KW - Heart failure

KW - Myocardial infarction

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