title: Characterization of microvascular and myocardial damage within perfusion defect area at myocardial contrast echocardiography in the subacute phase of myocardial infarction.
abstract: OBJECTIVE
  The anatomical correlates of perfusion defect (PD) at myocardial contrast echocardiography (MCE) in the subacute phase of ST-elevation myocardial infarction (STEMI) are currently unknown. The study aimed at assessing whether, in the subacute phase of STEMI, within MCE PD microvessels are anatomically damaged or if some vasodilation can be still elicited and if the PD correlates with the extent of myocardial necrosis.
  
  
  RESULTS
  Twenty-two post-percutaneous coronary intervention (PCI) patients underwent MCE 7 ± 1 days after STEMI, at baseline and after adenosine (ADN) administration. An area of completely non-opacified myocardium, corresponding to the area of the PD, was quantitated by planimetry. The area of the PD on MCE was compared with biochemical and imaging measures of myocardial necrosis: cardiac Troponin T peak (cTnT peak) and hyperenhanced area at gadolinium-enhanced cardiac magnetic resonance (Gd-CMR), respectively. After vasodilator stimulus, the area of the PD remained significantly unchanged when compared with the baseline value (P = 0.09 vs. baseline). The MCE index correlated at baseline with cTnT peak and Gd-CMR assessments of myocardial necrosis (P < 0.001). Also after ADN infusion, correlations between PD and extent of myocardial necrosis were similar to that assessed at baseline.
  
  
  CONCLUSIONS
  When assessed in the subacute phase of STEMI, the extent of the PD on MCE represents an area of both myocardial and microvascular necrosis.
authors: Institute of Cardiology, Catholic University of the Sacred Heart, Policlinico A Gemelli, Largo A Gemelli 8, 00168 Rome, Italy. lgaliuto@rm.unicatt.it
authors: Leonarda
authors: L
authors: Galiuto
authors: Gabriella
authors: G
authors: Locorotondo
authors: Lazzaro
authors: L
authors: Paraggio
authors: Alberto R
authors: AR
authors: De Caterina
authors: Antonio M
authors: AM
authors: Leone
authors: Elisa
authors: E
authors: Fedele
authors: Sabrina
authors: S
authors: Barchetta
authors: Italo
authors: I
authors: Porto
authors: Luigi
authors: L
authors: Natale
authors: Antonio G
authors: AG
authors: Rebuzzi
authors: Lorenzo
authors: L
authors: Bonomo
authors: Filippo
authors: F
authors: Crea
mesh_terms: D000241:Adenosine; D000368:Aged; D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D015415:Biomarkers / Q000097:blood; D003287:Contrast Media; D003326:Coronary Circulation; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography; D005260:Female; D005682:Gadolinium; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D015425:Myocardial Reperfusion / Q000379:methods; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D020107:Troponin T / Q000097:blood; D014665:Vasodilator Agents
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D020107:Troponin T; D014665:Vasodilator Agents; D005682:Gadolinium; D000241:Adenosine