[Study of post-infarction coronary perfusion using quantitative analysis of myocardial echocardiography with intravenous injection of contrast].
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.
Bodí
Vicent
V
Servicio de Cardiología. Hospital Clínic i Universitari, Universitat de València, Valencia, España. vicentbodi@hotmail.com
Sanchís
Juan
J
Losada
Antonio
A
García
Diego
D
Núñez
Julio
J
Pellicer
Mauricio
M
Millet
José
J
Chorro
Francisco J
FJ
Llácer
Angel
A
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
D003287:Contrast Media