Document Detail


Acute myocardial infarction early viability assessment by 64-slice computed tomography immediately after coronary angiography: comparison with low-dose dobutamine echocardiography.
MedLine Citation:
PMID:  17367662     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Early evaluation of myocardial viability in acute myocardial infarction is useful to guide therapy. Therefore, we assessed 64-slice computed tomography (CT) immediately after coronary angiography in this setting. BACKGROUND: Recent preliminary studies have shown the promising usefulness of late hyperenhancement multislice computed tomography (MSCT) for non-viability assessment. METHODS: Thirty-six patients admitted for a first acute myocardial infarction had a coronary angiogram early after admission followed by 64-slice CT without iodine reinjection. The 16 segments of the left ventricle depicted by the American Society of Echocardiography were graded: no, subendocardial, or transmural hyperenhancement. No or subendocardial hyperenhancement were expected to reflect viability. Two to 4 weeks later, the same segments' contractility was evaluated at rest. Low-dose dobutamine echocardiography was performed in case of akinetic segment at rest. RESULTS: Mean delay between coronary angiography and MSCT was 24 +/- 11 min (range 7 to 51 min). We compared 576 segments evaluated by each method. Agreement was noted for 560 segments (97%) and disagreement for 16 segments (3%). Thus, 64-slice CT after coronary angiography for an acute myocardial infarction had 98% sensitivity, 94% specificity, 97% accuracy, and 99% positive and 79% negative predictive values for detecting viable myocardial segments at a very early stage of an acute myocardial infarction. On a per-patient analysis, sensitivity, specificity, accuracy, and positive and negative predictive values were 92%, 100%, 94%, and 100% and 85%, respectively. CONCLUSIONS: A 64-slice CT after coronary angiography for an acute myocardial infarction is a promising method for early evaluation of viable myocardium.
Authors:
Michel Habis; André Capderou; Saïd Ghostine; Béatrice Daoud; Christophe Caussin; Jean-Yves Riou; Philippe Brenot; Claude Yves Angel; Bernard Lancelin; Jean-François Paul
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-03-06
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  49     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-19     Completed Date:  2007-04-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1178-85     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France. mhabis@ccml.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / methods
Cohort Studies
Coronary Angiography / methods
Dobutamine / diagnostic use*
Dose-Response Relationship, Drug
Echocardiography, Doppler / methods*
Electrocardiography
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Myocardial Contraction / physiology
Myocardial Infarction / radiography*,  therapy,  ultrasonography*
Probability
Risk Assessment
Sensitivity and Specificity
Stroke Volume
Tomography, Spiral Computed / methods*
Ventricular Function, Left / physiology
Chemical
Reg. No./Substance:
34368-04-2/Dobutamine

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