TY - JOUR
T1 - Ultrasonic tissue characterization predicts myocardial viability in early stage of reperfused acute myocardial infarction
AU - Takiuchi, Shin
AU - Ito, Hiroshi
AU - Iwakura, Katsuomi
AU - Taniyama, Yoshiaki
AU - Nishikawa, Nagahiro
AU - Masuyama, Tohru
AU - Hori, Masatsugu
AU - Higashino, Yorihiko
AU - Fujii, Kenshi
AU - Minamino, Takazo
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1998/2/3
Y1 - 1998/2/3
N2 - Background - The aim of the present study was to characterize temporal changes in cyclic variation of ultrasonic integrated backscatter (IBS), which reflects intrinsic contractile performance, in patients with reperfused acute myocardial infarction (AMI) and to elucidate the clinical value of tissue characterization in predicting myocardial viability. Methods and Results - We recorded short-axis IBS images before and 3, 7, and 21 days after reperfusion in 26 patients with AMI and obtained the cyclic variation of lBS in the normal and infarct zones. When cyclic variation showed synchrony and asynchrony, we expressed its magnitude as positive and negative values, respectively, called the phase-corrected magnitude. We also measured average wall motion score (dyskinesis, 4; normal, 0) of the infarct segments. The phase-corrected magnitude was lower in the infarct zone than in the normal zone before reperfusion (0.3±2.5 versus 5.2±1.7 dB, P<.05). At day 3, the phase-corrected magnitude increased by 2.1±2.6 dB despite no improvement in wall motion. Improvement in wall motion was observed only at day 21. The patients with the phase-corrected magnitude of ≤2.0 dB at day 3 showed significantly lower wall motion score at day 21 than did the other patients (1.7±0.6 versus 2.4±0.5, P<.01). Conclusions - In patients with AMI, cyclic variation of IBS is blunted during ischemia but recovers much faster after reperfusion than the improvement in wall motion. The greater phase-corrected magnitude at day 3 may be a predictor of better functional improvement.
AB - Background - The aim of the present study was to characterize temporal changes in cyclic variation of ultrasonic integrated backscatter (IBS), which reflects intrinsic contractile performance, in patients with reperfused acute myocardial infarction (AMI) and to elucidate the clinical value of tissue characterization in predicting myocardial viability. Methods and Results - We recorded short-axis IBS images before and 3, 7, and 21 days after reperfusion in 26 patients with AMI and obtained the cyclic variation of lBS in the normal and infarct zones. When cyclic variation showed synchrony and asynchrony, we expressed its magnitude as positive and negative values, respectively, called the phase-corrected magnitude. We also measured average wall motion score (dyskinesis, 4; normal, 0) of the infarct segments. The phase-corrected magnitude was lower in the infarct zone than in the normal zone before reperfusion (0.3±2.5 versus 5.2±1.7 dB, P<.05). At day 3, the phase-corrected magnitude increased by 2.1±2.6 dB despite no improvement in wall motion. Improvement in wall motion was observed only at day 21. The patients with the phase-corrected magnitude of ≤2.0 dB at day 3 showed significantly lower wall motion score at day 21 than did the other patients (1.7±0.6 versus 2.4±0.5, P<.01). Conclusions - In patients with AMI, cyclic variation of IBS is blunted during ischemia but recovers much faster after reperfusion than the improvement in wall motion. The greater phase-corrected magnitude at day 3 may be a predictor of better functional improvement.
KW - Echocardiography
KW - Myocardial contraction
KW - Myocardial infarction
KW - Reperfusion
KW - Ultrasonics
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U2 - 10.1161/01.CIR.97.4.356
DO - 10.1161/01.CIR.97.4.356
M3 - Article
C2 - 9468209
AN - SCOPUS:0032477839
VL - 97
SP - 356
EP - 362
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 4
ER -