title: Prediction of transmural extent of infarction with contrast echocardiographically derived index of myocardial blood flow and myocardial blood volume fraction: comparison with contrast-enhanced magnetic resonance imaging.
abstract: BACKGROUND
  We sought to determine the accuracy of myocardial contrast echocardiography (MCE)-derived index of myocardial blood flow and myocardial blood volume fraction (MBVF) in predicting transmural extent of infarction and wall-motion recovery.
  
  
  METHODS
  Low and high mechanical index MCE and contrast-enhanced magnetic resonance imaging were performed 5 to 7 days after successful percutaneous revascularization in 30 patients with acute myocardial infarction and regional wall-motion change was assessed 3 months later. The index of myocardial blood flow was calculated as A x beta (dB/s) using the equation y = A (1 - e(-beta t)), which fits the replenishment curve of low mechanical index MCE. The MBVF (mL/100 g myocardium) was calculated as 100 x 10(relative contrast intensity [CI]/10), using the relative CI by subtracting the cavity CI from the adjacent transmural CI using high mechanical index MCE. The contrast-enhanced magnetic resonance imaging-derived transmural extent of delayed hyperenhancement (DE) in 16 segments were measured and compared with corresponding MCE data.
  
  
  RESULTS
  Among 480 segments, 382 measurable segments were subdivided into 5 groups as follows: no DE, 1% to 25% DE, 26% to 50% DE, 51% to 75% DE, and 76% to 100% DE. An increment of the extent of DE was significantly related to a decrement of A x beta (P < .001) and MBVF (P < .001). The optimal cut-off MBVF for predicting greater than 50% DE was 1.92 mL (sensitivity 82%, specificity 73%, P < .01), and persistently dysfunctional motion was 1.81 mL (sensitivity 74%, specificity 75%, P < .01).
  
  
  CONCLUSIONS
  The MCE-derived A x beta and MBVF can be effective predictors of transmural extent of infarction and wall-motion recovery in the reperfused acute myocardial infarction.
authors.affiliation: Cardiology Division, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Choi
authors.forename: Hye-Sun
authors.initials: HS
authors.lastname: Seo
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
authors.forename: Hyun-Joo
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jeong-Ah
authors.initials: JA
authors.lastname: Ahn
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.forename: Byoung-Wook
authors.initials: BW
authors.lastname: Choi
authors.forename: Seok-Min
authors.initials: SM
authors.lastname: Kang
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Ha
authors.forename: Se-Joong
authors.initials: SJ
authors.lastname: Rim
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
mesh_terms: D001783:Blood Flow Velocity; D001810:Blood Volume; D003287:Contrast Media; D003326:Coronary Circulation; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000145:classification / Q000150:complications / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000145:classification / Q000175:diagnosis* / Q000209:etiology
chemical_list: D003287:Contrast Media