title: The prognostic value of contrast echocardiography in the prediction of the recovery of left ventricular function in patients with acute anterior myocardial infarction.
abstract: BACKGROUND
  The immediate and complete restoration of perfusion in patients with acute myocardial infarction (MI) leads to the survival of myocardial cells in the initially ischaemic risk area and makes the recovery of left ventricular contractile function possible.
  
  
  OBJECTIVE
  The goal of the study was to assess the utility of contrast echocardiography (CE) in the prediction of left ventricular function recovery in patients with AMI treated by percutaneous coronary intervention (PCI).
  
  
  METHODS
  Eighty six patients (aged 58.4+/-11.2) with anterior AMI, treated by PCI of the left anterior descending coronary artery, were included in the study. Two-dimensional and contrast (Optison) echocardiography were performed immediately before and after PCI, and three days post-PCI. Myocardial contrasting was assessed using the following criteria: 0 -- lack of perfusion; 0.5 -- partial perfusion; 1 -- normal perfusion. On the third day post-PCI, the regional myocardial contrast index was evaluated as the mean value in dyssynergic left ventricular segments (LVRCstI). After three months, the left ventricular regional contractility index (LVRCtrctI) was calculated as the sum of points in the segments which were dyssynergic in the initial study, divided by their number.
  
  
  RESULTS
  90% of segments with perfusion defects three days post-PCI demonstrated contractility defects (hypokinesia or akinesia) three months post-PCI. LVRCstI three days post-PCI correlated strongly with LVRCtrctI three months post-PCI (R2=0.7696). The sensitivity, specificity and accuracy of EC three days post-PCI in the prediction of recovery of left ventricular function were 88%, 80% and 86%, respectively.
  
  
  CONCLUSIONS
  The presence of myocardial perfusion in the region supplied by the infarct-related artery three days post-MI is indicative of myocardial survival and predicts the recovery of contractile function in this region in long-term observation.
authors.affiliation: Klinika Chorób Serca i Naczyń CM UJ, ul. Pradnicka 80, 31202 Kraków, Poland. molszowska@szpitaljp2.krakow.pl
authors.forename: Maria
authors.initials: M
authors.lastname: Olszowska
authors.forename: Wiesława
authors.initials: W
authors.lastname: Tracz
authors.forename: Marta
authors.initials: M
authors.lastname: Hlawaty
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003326:Coronary Circulation; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology; D020127:Recovery of Function; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D016277:Ventricular Function, Left