Document Detail


Relation of ultrasonic tissue characterization with integrated backscatter to contractile reserve in patients with chronic coronary artery disease.
MedLine Citation:
PMID:  14579920     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previous studies have shown that viable but stunned myocardium displays contractile reserve and exhibits cardiac cycle-dependent variations of integrated backscatter (CVIB), whereas infarcted myocardium does not. HYPOTHESIS: This study was designed to clarify whether assessment of the acoustic properties of the myocardium can predict contractile reserve in patients with chronic coronary artery disease (CAD). METHODS: In all, 21 patients with chronic CAD and 19 normal control subjects were studied. The magnitude of CVIB of the myocardium was measured in the basal and mid segment of the anterior septum and posterior wall of the left ventricle, using a real-time, two-dimensional integrated backscatter imaging system. The results were compared with the percent systolic wall thickening and the wall motion before and after revascularization. The wall motion was graded as normal, hypokinetic, or akinetic, and contractile reserve was considered present when an akinetic or hypokinetic segment improved after revascularization. RESULTS: The average magnitude of CVIB was lower among dysfunctional segments of CAD than among normal segments of controls (3.73 +/- 1.71 vs. 6.35 +/- 0.69, p < 0.001). Of the 77 segments examined, 38 showed reversible dysfunction. Before revascularization, percent systolic wall thickening was similar among segments showing contractile reserve compared with those with persistent dysfunction myocardium (17.97 +/- 8.41 vs. 16.83 +/- 6.37%, p = 0.19), and the mean CVIB was significantly greater in segments with than in those without contractile reserve (4.73 +/- 1.47 vs. 2.75 +/- 1.31, p < 0.001). The CVIB above 3 dB before percutaneous transluminal coronary angioplasty predicted segments with contractile reserve with a sensitivity and specificity of 84.2 and 79.5%, respectively. CONCLUSIONS: Cardiac cycle-dependent variations of integrated backscatter reflected myocardial contractility and functional capacity of the myocardium. They predicted segmental contractile reserve in patients with CAD.
Authors:
Xiaojun Hu; Jinming Wang; Yougang Sun; Xia Jiang; Bin Sun; Haixia Fu; Ruiqiang Guo
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  26     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-28     Completed Date:  2004-03-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  485-8     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China. hxjsuper@.163.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Cardiomyopathies / physiopathology,  ultrasonography*
Case-Control Studies
Chronic Disease
Coronary Artery Disease / physiopathology*,  therapy
Echocardiography*
Female
Humans
Male
Middle Aged
Myocardial Contraction / physiology*
Myocardial Revascularization
Ventricular Dysfunction, Left / physiopathology,  ultrasonography

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


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