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Assessment of myocardial viability using multidetector computed tomography in patients with reperfused acute myocardial infarction.
MedLine Citation:
PMID:  22749383     Owner:  NLM     Status:  In-Data-Review    
AIM: To assess the prognostic value of 64-section multidetector computed tomography (MDCT) to predict follow-up myocardial dysfunction and functional recovery after reperfusion therapy in patients with acute myocardial infarction (MI) as defined by echocardiography.
MATERIALS AND METHODS: After reperfusion therapy for acute MI, 71 patients underwent two-phase contrast-enhanced MDCT and follow-up echocardiography. MDCT findings were compared with echocardiographic findings using kappa statistics. The areas under the receiver operating characteristic curves (AUCs) and the odds ratios (ORs) of early perfusion defects (EPD), delayed enhancement (DE), and residual perfusion defects (RPD) for predicting follow-up myocardial dysfunction and functional recovery were calculated on a segmental basis.
RESULTS: The presence of transmural EPD (EPD(TM)) or RPD showed good agreement (k = 0.611 and 0.658, respectively) with follow-up myocardial dysfunction, while subendocardial EPD (EPD(sub)) or subendocardial DE (DE(sub)) showed fair agreement with follow-up myocardial dysfunction (k = 0.235 and 0.234, respectively). The AUC of RPD (0.796) was superior (p < 0.001 and 0.031, respectively) to those of EPD(TM) (0.761) and DE(TM) (0.771). The presence of EPD(TM), DE(TM), and RPD were significant, independent positive predictors of follow-up myocardial dysfunction (OR = 6.4, 1.9, and 9.8, respectively). EPD(TM) was a significant, independent negative predictor of myocardial functional recovery (OR = 0.13).
CONCLUSION: Abnormal myocardial attenuation on two-phase MDCT after reperfusion therapy may provide promising information regarding myocardial viability in patients with acute MI.
T Kim; B J Choi; D K Kang; J S Sun
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical radiology     Volume:  67     ISSN:  1365-229X     ISO Abbreviation:  Clin Radiol     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1306016     Medline TA:  Clin Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  754-65     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Department of Radiology, Ajou University School of Medicine, Suwon, South Korea.
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