Improved prediction of outcome by contrast echocardiography determined left ventricular remodelling parameters compared to unenhanced echocardiography in patients following acute myocardial infarction.
OBJECTIVE
Contrast echocardiography has been shown to be a more accurate method of assessing left ventricular (LV) remodelling compared with unenhanced echocardiography after acute myocardial infarction (AMI). However, whether this translated into improved prediction of outcome is not known.


RESULTS
Accordingly, a total of 89 consecutive patients undergoing contrast echocardiography and unenhanced echocardiography 7 to 10 days after AMI and reperfusion therapy were followed up for cardiac death (CD) and AMI. LV ejection fraction (LVEF), LV end-systolic volume (ESV), and LV end-diastolic volume were assessed by the two methods independently. Outcome data were obtained (mean 46 +/- 16 months).There were 15 (17%) events (eight CDs and seven AMIs). LVEF and ESV with contrast echocardiography were found to be independent multivariable predictors of CD (P = 0.04 and P = 0.02, respectively) and CD or AMI (P = 0.02 and P = 0.01, respectively). Furthermore, LVEF and ESV with contrast echocardiography provided incremental information for the prediction of CD (P = 0.004 and P = 0.004, respectively) and CD or AMI (P = 0.02 and P = 0.03, respectively).


CONCLUSIONS
Contrast echocardiography provided improved prediction of outcome compared with unenhanced echocardiography following AMI.
Dwivedi
Girish
G
Department of Cardiovascular Medicine, Northwick Park Hospital, Northwick Park Institute of Medical Research, Harrow, UK.
Janardhanan
Rajesh
R
Hayat
Sajad A
SA
Lim
Tiong K
TK
Senior
Roxy
R
D000418:Albumins / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage*; D017023:Coronary Angiography; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015588:Observer Variation; D017063:Outcome Assessment, Health Care; D010743:Phospholipids / Q000008:administration & dosage*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020257:Ventricular Remodeling
D000418:Albumins; D003287:Contrast Media; C099458:FS 069; D005466:Fluorocarbons; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride