title: The comparison of contrast echocardiography and tissue Doppler imaging for evaluation of reperfused myocardium in patients with acute anterior myocardial infarction.
abstract: BACKGROUND
  Prediction of functional myocardial recovery post acute myocardial infarction should be based not only on flow patency of the infarct related artery (IRA) but also on the quality of microcirculation in at-risk segments. Myocardial blush grade (MBG) is a method of perfusion assessment which has an established value in prediction of both ventricular remodelling and prognosis. However, its invasive character encourages the search for other methods able to reflect myocardial recovery following successful reperfusion. Echocardiography is an imaging modality which has the potential to assess, noninvasively, myocardial perfusion and, quantitatively, the loss of contractile function. The aim of this study was to compare the values of myocardial contrast echocardiography (MCE), MBG and tissue Doppler imaging (TDI) in the assessment of microcirculation in patients with first acute myocardial infarction of the anterior wall.
  
  
  METHODS
  The study group consisted of 39 patients (15 female and 24 male, mean age 58.8 +/- 12.2 years) with first anterior infarction within 6 hours of chest pain onset. All patients underwent angioplasty of the anterior descending artery (LAD). Myocardial blush grade was assessed directly after angioplasty, whereas MCE using SonoView contrast accompanied by TDI study was performed 4 days thereafter.
  
  
  RESULTS
  Neither of the quantitative MCE parameters showed significant correlation with perfusion assessed by MBG. Significant negative correlation of MBG was found with maximal systolic strain ( e) (R = -0.51, p = 0.003) and post systolic shortening (R = -0.49, p = 0.007) in infarcted segments, but this was not the case with the unaffected segments.
  
  
  CONCLUSIONS
  Use of MCE in the assessment of myocardial perfusion in myocardial infarction is limited, as shown by poor correlation with MBG. The presence of impaired contractile function by TDI corresponds better with myocardial perfusion than MCE does.
authors.affiliation: Silesian Centre for Heart Disease in Zabrze, Poland. streb@wp.pl
authors.forename: Witold
authors.initials: W
authors.lastname: Streb
authors.forename: Agata
authors.initials: A
authors.lastname: Duszańska
authors.forename: Joanna
authors.initials: J
authors.lastname: Stabryła-Deska
authors.forename: Sławomir
authors.initials: S
authors.lastname: Pluta
authors.forename: Marcin
authors.initials: M
authors.lastname: Swierad
authors.forename: Tomasz
authors.initials: T
authors.lastname: Was
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Kalarus
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kukulski
mesh_terms: D003326:Coronary Circulation / Q000502:physiology*; D018450:Disease Progression; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010743:Phospholipids / Q000008:administration & dosage; D020127:Recovery of Function / Q000502:physiology*; D012039:Regional Blood Flow / Q000502:physiology*; D015203:Reproducibility of Results; D013459:Sulfur Hexafluoride / Q000008:administration & dosage
chemical_list: D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride