title: Ultrasonic tissue characterization in predicting residual ischemia and myocardial viability for patients with acute myocardial infarction.
abstract: The identification of viable myocardium and residual ischemia in patients with acute myocardial infarction has important prognostic implications. The ultrasonic tissue characterization with integrated backscatter and dobutamine-atropine stress echocardiography were performed 8.3+/-3 days after AMI in 30 patients. After coronary angioplasty for the residual stenosis of infarct-related artery, both modalities were repeated. The parameter obtained from ultrasonic tissue characterization, phase-weighted variation, could differentiate the myocardium with residual coronary stenosis or nonviable myocardium from the viable myocardium without residual coronary stenosis (p < 0.001). Using the cutoff value of 5.8 dB, the sensitivity, specificity and accuracy for detecting viable myocardium without residual coronary stenosis were 75%, 100% and 90.2%, respectively. The phase-weighted variation of the viable infarction zone restored after the coronary stenosis was relieved. In contrast, the nonviable myocardium had a small phase-weighted variation that was irrelevant to the patency of the infarct-related artery. The ultrasonic tissue characterization may be used in identifying patients with acute myocardial infarction whose infarction zones are viable without residual ischemia.
authors.affiliation: Department of Internal Medicine (Cardiology Section), National Taiwan University Hospital, Taipei.
authors.forename: L C
authors.initials: LC
authors.lastname: Lin
authors.forename: C C
authors.initials: CC
authors.lastname: Wu
authors.forename: Y L
authors.initials: YL
authors.lastname: Ho
authors.forename: M F
authors.initials: MF
authors.lastname: Chen
authors.forename: C S
authors.initials: CS
authors.lastname: Liau
authors.forename: Y T
authors.initials: YT
authors.lastname: Lee
mesh_terms: D017130:Angioplasty; D001285:Atropine; D017023:Coronary Angiography; D003327:Coronary Disease / Q000628:therapy; D004280:Dobutamine; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015912:Thrombolytic Therapy
chemical_list: D004280:Dobutamine; D001285:Atropine