Document Detail

Wall thickening assessment with tissue harmonic echocardiography results in improved risk stratification for patients with non-ST-segment elevation acute chest pain.
MedLine Citation:
PMID:  15036026     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To demonstrate whether the improved imaging quality gained by using tissue harmonic echocardiography in place of fundamental echocardiography results in the improved risk stratification of patients presenting with non-ST-elevation acute chest pain. METHODS AND RESULTS: Eighty patients with over 30 min of non-ST-elevation chest pain that had lasted less than 6 h were recruited. All patients underwent resting tissue harmonic and fundamental echocardiographic scans. Diagnosis for acute myocardial infarction was made on a 24 h creatine kinase-MB sample. Echocardiographic images were reported by two experienced blinded observers. Patients were followed up at least 4 months after admission. Endpoints included all-cause mortality, non-fatal myocardial infarction and revascularisation procedures. Tissue harmonic echocardiography allowed assessment of all myocardial segments in all patients compared to 43/78 patients ( p<0.001 ) with fundamental echocardiography. A wall thickening abnormality demonstrated on tissue harmonic echocardiography and not fundamental echocardiography was a significant predictor of index myocardial infarction on admission ( p<0.007 ) and for an adverse cardiac event during follow up ( p=0.002 ). CONCLUSIONS: Tissue harmonic echocardiography is superior to fundamental echocardiography for accurate assessment of systolic wall thickening and hence risk stratification for patients presenting with acute chest pain and non-diagnostic electrocardiogram changes.
M Hickman; J M A Swinburn; R Senior
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  5     ISSN:  1525-2167     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-23     Completed Date:  2004-11-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  142-8     Citation Subset:  IM    
Department of Cardiovascular Medicine, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK.
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MeSH Terms
Acute Disease
Angioplasty, Transluminal, Percutaneous Coronary
Chest Pain / diagnosis*,  epidemiology*,  therapy
Coronary Artery Bypass
Follow-Up Studies
Great Britain
Heart Conduction System / pathology,  ultrasonography
Image Enhancement
Middle Aged
Multivariate Analysis
Myocardial Infarction / diagnosis,  epidemiology,  therapy
Predictive Value of Tests
Prospective Studies
Risk Factors
Sensitivity and Specificity
Treatment Outcome
Comment In:
Eur J Echocardiogr. 2004 Mar;5(2):97-8   [PMID:  15036017 ]

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