Document Detail


Feasibility of prediction of myocardial viability with Doppler tissue imaging following percutaneous coronary intervention for ST elevation anterior myocardial infarction.
MedLine Citation:
PMID:  19121567     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In patients with acute ST elevation myocardial infarction (STEMI), it is clinically important to determine the viability of akinetic segments soon after acute reperfusion therapy. The purpose of this study was to determine whether Doppler tissue imaging can predict myocardial viability in this clinical setting. METHODS: Twenty-four consecutive patients with the first acute anterior STEMI with akinetic apical segments were enrolled. Color-coded Doppler tissue imaging was performed. Myocardial velocity and strain values were determined from the septal and lateral walls at the normal basal and akinetic apical levels of the left ventricle on day 1 after percutaneous coronary intervention. The presence of isovolumic contraction of tissue velocity (TVivc) and strain rate (SRivc) were also determined. RESULTS: Twenty patients (mean age 62 +/- 15 years; 11 men) returned for follow-up echocardiography to assess wall motion recovery and viability. Ten patients who had recovery of akinetic segments showed lower baseline E/e' ratios than those without recovery (13.4 +/- 5.9 vs 19.1 +/- 5.7; P = .04). There was no difference between 19 recovered and 21 nonrecovered apical segments in all TV, SR, and strain values except early diastolic SR (SRe; 0.64 +/- 0.35 vs 0.43 +/- 0.25 s(-1); P = .04) at day 1. With a cutoff value of 0.32 s(-1) for SRe, the receiver operating characteristic curve for the prediction of recovery showed the highest sensitivity of 84%. The presence of TVivc had sensitivity and specificity of 79% and 33%, respectively, and for SRivc, sensitivity and specificity were 84% and 63%, respectively. With the combination of SRe and SRivc, specificity was increased to 78%. CONCLUSION: Patients with functional recovery from anterior STEMI showed better diastolic function, better SRe, and more isovolumic contraction. These parameters appear to be promising predictors for myocardial viability, and SR imaging was found to be a better method than TV imaging for the identification of viable myocardium in patients with STEMIs who underwent percutaneous coronary intervention.
Authors:
Seong-Mi Park; Chinami Miyazaki; Abhiram Prasad; Charles J Bruce; Krishnaswamy Chandrasekaran; Charanjit Rihal; Malcolm R Bell; Jae K Oh
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2009-01-01
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  22     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-03     Completed Date:  2009-06-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  183-9     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Korea University College of Medicine, Seoul, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Echocardiography, Doppler / methods*
Elasticity Imaging Techniques / methods*
Feasibility Studies
Female
Humans
Male
Middle Aged
Myocardial Infarction / complications,  surgery*,  ultrasonography*
Myocardial Stunning / etiology,  prevention & control*,  ultrasonography*
Reproducibility of Results
Sensitivity and Specificity
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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