Use of echocardiography for predicting myocardial viability in patients with reperfused anterior wall myocardial infarction

Katsuomi Iwakura, Hiroshi Itoh, Nagahiro Nishikawa, Ken Sugimoto, Yasunori Shintani, Koichi Yamamoto, Yorihiko Higashino, Tohru Masuyama, Masatsugu Hori, Kenshi Fujii

Research output: Contribution to journalArticle

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Abstract

Dobutamine stress echocardiography (DSE), myocardial contrast echocardiography (MCE), and ultrasonic tissue characterization with integrated backscatter are useful methods for assessing myocardial viability in acute myocardial infarction. In this study, we compared the potential of 3 methods for predicting myocardial viability in 38 patients with reperfused anterior wall acute myocardial infarction. We performed MCE shortly after coronary reperfusion with an intracoronary injection of microbubbles. We recorded 2-dimensional integrated backscatter images at rest and, then, performed low-dose (10 μg/kg/min) DSE 3 days later. In integrated backscatter images, we placed the region of interest in the midwall of the myocardial segment to reconstruct the cyclic variation of myocardial integrated backscatter. The myocardial segment was judged viable when it showed active contraction 3 months later. Among 74 segments analyzed, 34 were judged viable. Presence of contractile response during DSE predicted segmental viability with 91% sensitivity and 78% specificity. Intense and homogenous contrast enhancement with MCE predicted viability with 82% sensitivity and 73% specificity. The presence of synchronous contraction of cyclic variation predicted myocardial viability with 79% sensitivity and 83% specificity. There were no differences in sensitivity and specificity among the 3 methods. Thus, MCE and ultrasonic tissue characterization can predict myocardial viability as accurately as DSE in patients with acute myocardial infarction. The logistics of the methods may determine clinical application. Copyright (C) 2000 Excerpta Medica Inc.

Original languageEnglish
Pages (from-to)744-748
Number of pages5
JournalAmerican Journal of Cardiology
Volume85
Issue number6
DOIs
Publication statusPublished - Mar 15 2000
Externally publishedYes

Fingerprint

Anterior Wall Myocardial Infarction
Stress Echocardiography
Echocardiography
Sensitivity and Specificity
Ultrasonics
Myocardial Infarction
Microbubbles
Myocardial Reperfusion
Injections

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Use of echocardiography for predicting myocardial viability in patients with reperfused anterior wall myocardial infarction. / Iwakura, Katsuomi; Itoh, Hiroshi; Nishikawa, Nagahiro; Sugimoto, Ken; Shintani, Yasunori; Yamamoto, Koichi; Higashino, Yorihiko; Masuyama, Tohru; Hori, Masatsugu; Fujii, Kenshi.

In: American Journal of Cardiology, Vol. 85, No. 6, 15.03.2000, p. 744-748.

Research output: Contribution to journalArticle

Iwakura, K, Itoh, H, Nishikawa, N, Sugimoto, K, Shintani, Y, Yamamoto, K, Higashino, Y, Masuyama, T, Hori, M & Fujii, K 2000, 'Use of echocardiography for predicting myocardial viability in patients with reperfused anterior wall myocardial infarction', American Journal of Cardiology, vol. 85, no. 6, pp. 744-748. https://doi.org/10.1016/S0002-9149(99)00852-8
Iwakura, Katsuomi ; Itoh, Hiroshi ; Nishikawa, Nagahiro ; Sugimoto, Ken ; Shintani, Yasunori ; Yamamoto, Koichi ; Higashino, Yorihiko ; Masuyama, Tohru ; Hori, Masatsugu ; Fujii, Kenshi. / Use of echocardiography for predicting myocardial viability in patients with reperfused anterior wall myocardial infarction. In: American Journal of Cardiology. 2000 ; Vol. 85, No. 6. pp. 744-748.
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