title: [Study of post-infarction coronary perfusion using quantitative analysis of myocardial echocardiography with intravenous injection of contrast].
abstract: OBJECTIVE
  After a myocardial infarction, damage to the microcirculation indicates a worse prognosis. We compared the usefulness of the quantitative analysis of myocardial contrast echocardiography with intravenous injection of contrast (MCE-iv) with intracoronary injection (MCE-ic) for analyzing coronary perfusion.
  
  
  METHODS
  We studied 42 patients with a first ST-elevation myocardial infarction, single-vessel disease and a patent artery (TIMI 3, stenosis < 50%). Myocardial perfusion in segments in the infarct-related area was quantified (normalized scale 0-1) with MCE-ic (bolus of Levovist, real-time imaging, perfusion considered normal if > 0.75) and MCE-iv (perfusion of SonoVue, single-image capture in 1 out of each 6 cycles with trigger set at end-systole, perfusion considered normal if > 0.9). Perfusion was considered abnormal if 2 or more segments showed altered perfusion.
  
  
  RESULTS
  Quantification with MCE-iv took 5 +/- 1 minutes. No side effects were observed. MCE-ic was normal in 141 segments (80%) out of 176 segments included in the infarcted area, whereas 35 segments (20%) showed abnormal perfusion. MCE-ic was normal in 31 patients (74%) and was altered in 11 cases (26%). Normal perfusion with MCE-iv had a sensitivity of 91%, a specificity of 84% and a kappa index of 0.67 for predicting normal perfusion with MCE-ic (r = 0.86; P < .0001 between the two techniques).
  
  
  CONCLUSIONS
  In comparison with MCE-ic, quantitative analysis of single images captured during intravenous perfusion of contrast is an easy, rapid and valid method for analyzing postinfarction coronary perfusion.
authors.affiliation: Servicio de Cardiología. Hospital Clínic i Universitari, Universitat de València, Valencia, España. vicentbodi@hotmail.com
authors.forename: Vicent
authors.initials: V
authors.lastname: Bodí
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchís
authors.forename: Antonio
authors.initials: A
authors.lastname: Losada
authors.forename: Diego
authors.initials: D
authors.lastname: García
authors.forename: Julio
authors.initials: J
authors.lastname: Núñez
authors.forename: Mauricio
authors.initials: M
authors.lastname: Pellicer
authors.forename: José
authors.initials: J
authors.lastname: Millet
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Chorro
authors.forename: Angel
authors.initials: A
authors.lastname: Llácer
mesh_terms: D006328:Cardiac Catheterization; D003287:Contrast Media; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy; D015425:Myocardial Reperfusion / Q000379:methods; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media