title: [Usefulness of parametric imaging-based quantitative myocardial contrast echocardiography in predicting the functional recovery of akinetic segments following primary angioplasty in acute myocardial infarction patients].
abstract: OBJECTIVE
  Myocardial contrast echocardiography (MCE) is useful for predicting the functional recovery of akinetic segments in patients undergoing primary angioplasty after acute myocardial infraction (AMI). Recently, parametric imaging-based quantitative MCE has been developed for measuring perfusion. Our aims were: a) to measure perfusion in akinetic myocardial segments in patients undergoing primary angioplasty using parametric imaging-based quantitative MCE; and b) to assess the usefulness of these measurements in predicting functional recovery of these segments.
  
  
  METHODS
  The study group comprised 49 consecutive patients undergoing primary angioplasty. Both MCE and standard echocardiography were performed between 2 and 5 days after AMI. Six months later, additional standard echocardiography and coronary angiography were performed. Perfusion was quantified independently off-line from parametric images.
  
  
  RESULTS
  The patients' mean age was 62.3+/-14.5 years (39 men; 79.2%). Some 170 akinetic segments were detected. Of these, 105 (62.1%) recovered function. The quantitative MCE parameter that best predicted functional recovery was myocardial blood flow velocity (beta): the area under the receiver operating characteristic (ROC) curve was 0.96 (95% CI, 0.92-0.99). For a cut-off point of 31 dB/s, the sensitivity was 87.62%, the specificity was 95.31%, the positive predictive value was 96.8%, and the negative predictive value was 82.43%. These results were better than those obtained using qualitative methods for assessing myocardial perfusion.
  
  
  CONCLUSIONS
  Perfusion measurement by parametric imaging-based quantitative MCE is useful for predicting the functional recovery of akinetic segments in patients undergoing primary angioplasty after AMI. The technique provides superior information to older qualitative methods.
authors.affiliation: Instituto Cardiovascular, Departamento de Ecocardiografía, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Viviana
authors.initials: V
authors.lastname: Serra
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Pérez de Isla
authors.forename: José
authors.initials: J
authors.lastname: Zamorano
authors.forename: Carlos
authors.initials: C
authors.lastname: Almería
authors.forename: José L
authors.initials: JL
authors.lastname: Rodrigo
authors.forename: María
authors.initials: M
authors.lastname: Pérez
authors.forename: José
authors.initials: J
authors.lastname: Florit
authors.forename: Luis
authors.initials: L
authors.lastname: Azcona
authors.forename: Rosa A
authors.initials: RA
authors.lastname: Hernández
authors.forename: Carlos
authors.initials: C
authors.lastname: Macaya
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003287:Contrast Media; D017023:Coronary Angiography; D003326:Coronary Circulation; D003627:Data Interpretation, Statistical; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000628:therapy*; D010743:Phospholipids; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012984:Software; D015607:Stents; D013459:Sulfur Hexafluoride
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride