Myocardial perfusion assessed by contrast echocardiography correlates with angiographic perfusion parameters in patients with a first acute myocardial infarction successfully treated with angioplasty.
BACKGROUND
Angiographic flow in an epicardial artery does not define perfusion at the microvascular level.


OBJECTIVE
To compare myocardial contrast echocardiography (MCE) with angiographic methods of assessing microvascular reperfusion in patients with acute myocardial infarction (AMI).


METHODS
One hundred consecutive patients with a first ST segment elevation myocardial infarction and single-vessel disease were successfully treated with primary percutaneous coronary intervention. Regional contrast score index (RCSI), corrected Thrombolysis In Myocardial Infarction (TIMI) frame count (cTFC), TIMI myocardial perfusion grade (TMPG) and myocardial blush grade were evaluated.


RESULTS
Among 717 asynergic segments on MCE, 168 revealed a lack of perfusion. TMPG and cTFC correlated significantly with RCSI (P=0.031 and P=0.027, respectively). Myocardial blush grade did not correlate with RCSI (P=0.067). Patients with anterior AMI had significantly more segments with a perfusion defect on MCE than patients with inferior AMI (P=0.0001).


CONCLUSIONS
MCE results correlate with angiographic methods of perfusion assessment such as TMPG and cTFC. Anterior AMI is associated with a greater extent of perfusion defect. MCE results correlate also with recovery of systolic left ventricular function and clinical outcome at six month follow-up.
Tomaszuk-Kazberuk
Anna
A
Department of Cardiology, University Hospital in Bialystok, Poland. walkaz@poczta.fm
Sobkowicz
Bozena
B
Kaminski
Karol
K
Gugala
Kamil
K
Mezynski
Grzegorz
G
Dobrzycki
Slawomir
S
Lewczuk
Anna
A
Kazberuk
Waldemar
W
Musial
Wlodzimierz J
WJ
D000328:Adult; D000368:Aged; D000418:Albumins; D015906:Angioplasty, Balloon, Coronary; D002932:Cineangiography; D003131:Combined Modality Therapy; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D023903:Coronary Restenosis / Q000175:diagnosis* / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D005466:Fluorocarbons; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012680:Sensitivity and Specificity; D015607:Stents; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology
D000418:Albumins; D003287:Contrast Media; C099458:FS 069; D005466:Fluorocarbons