title: Contrast echocardiography using intravenous octafluoropropane and real-time perfusion imaging predicts functional recovery after acute myocardial infarction.
abstract: Akinesia after acute myocardial infarction (MI) may be reversible, secondary to stunning, or irreversible, as a result of extensive myocyte necrosis. Distinguishing these 2 entities soon after MI is difficult, but has important clinical implications. The current study assessed the use of intravenous myocardial contrast echocardiography (MCE) in this setting. A total of 35 patients were studied 2 (+/- 1) days after an acute MI. Of these, 31 (91%) underwent myocardial revascularization. Perfusion was assessed using real-time MCE and an intravenous infusion of octafluoropropane microbubbles. Repeated echocardiograms were obtained 56 (+/- 29) days later. Normal perfusion predicted functional recovery with a positive predictive value of 66% and a negative predictive value of 81%. The accuracy of the technique was superior in myocardial segments supplied by the left anterior descending coronary artery (positive and negative predictive value: 70% and 90%, respectively). In multivariable analysis, the mean MCE perfusion score in akinetic segments was the most powerful independent predictor of functional recovery (odds ratio 8.6, P =.02). These data suggest that real-time intravenous MCE is a useful predictor of functional recovery of akinetic myocardium after acute MI.
authors.affiliation: Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Graham S
authors.initials: GS
authors.lastname: Hillis
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Mulvagh
authors.forename: Madhavi
authors.initials: M
authors.lastname: Gunda
authors.forename: Mary E
authors.initials: ME
authors.lastname: Hagen
authors.forename: Guy S
authors.initials: GS
authors.lastname: Reeder
authors.forename: Jae K
authors.initials: JK
authors.lastname: Oh
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D004452:Echocardiography; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren