Ultrasonic tissue characterization predicts left ventricular remodeling in patients with acute anterior myocardial infarction after primary coronary angioplasty.
OBJECTIVE
The aim of this study was to assess the role of cyclic variation (CV) of myocardial integrated backscatter (IBS) in the prediction of left ventricular (LV) remodeling in patients with anterior acute myocardial infarction (AMI) after primary coronary angioplasty.


BACKGROUND
Some studies have shown that the CV of myocardial IBS predicts myocardial viability for patients with AMI.


METHODS
We recorded short-axis IBS images within 24 hours of angioplasty in 80 patients with anterior AMI. Two parameters were measured: the magnitude of CV and the normalized time delay (NTD). The increase in LV end-diastolic volume (LVEDV) at 4 weeks (DeltaLVEDV) was defined as LV remodeling (>20% increase from baseline).


RESULTS
Patients were divided into two groups according to LV remodeling status: the remodeling group (n = 41) and the nonremodeling group (n = 39). There was a significant difference in the magnitude of CV between the two groups (5.11 +/- 1.47 vs 5.96 +/- 189 dB, P < .05), and the NTD was significantly different in the two groups (1.57 +/- 0.31 vs 1.23 +/- 0.32, P < .0001). The correlation between the magnitude of CV and DeltaLVEDV was significant but weak (r = -0.338, P < .01). There was significant correlation between NTD and DeltaLVEDV (r = 0.443, P < .0001). Using NTD greater than 1.35 as the optimal cutoff, the sensitivity, specificity, and positive and negative predictive values to predict LV remodeling were 82%, 86%, 87%, and 80%, respectively.


CONCLUSIONS
Myocardial IBS, especially NTD, is useful for predicting LV remodeling in patients with AMI after primary coronary angioplasty.
Ohara
Yoshikazu
Y
Division of Cardiology, Tokushima Red Cross Hospital, Tokushima, Japan. yoshio@tokushima-med.jrc.or.jp
Hiasa
Yoshikazu
Y
Hosokawa
Shinobu
S
Suzuki
Naoki
N
Takahashi
Takefumi
T
Kishi
Koichi
K
Ohtani
Ryuji
R
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control*; D020257:Ventricular Remodeling