title: Prognostic Value of Real Time Myocardial Contrast Echocardiography after Percutaneous Coronary Intervention.
abstract: Real time myocardial contrast echocardiography (RTMCE) is a cost-effective and simple method to quantify coronary flow reserve (CFR). We aimed to determine the value of RTMCE to predict cardiac events after percutaneous coronary intervention (PCI). We have studied myocardial blood volume (A), velocity (β), flow indexes (MBF, A × β), and vasodilator reserve (stress-to-rest ratios) in 36 patients with acute coronary syndrome (ACS) who underwent PCI. CFR (MBF at stress/MBF at rest) was calculated for each patient. Perfusion scores were used for visual interpretation by MCE and correlation with TIMI flow grade. In qualitative RTMCE assessment, post-PCI visual perfusion scores were higher than pre-PCI (Z = -7.26, P < 0.01). Among 271 arteries with TIMI flow grade 3 post-PCI, 72 (36%) did not reach visual perfusion score 1. The β- and A × β-reserve of the abnormal segments supplied by obstructed arteries increased after PCI comparing to pre-PCI values (P < 0.01). Patients with adverse cardiac events had significantly lower β- and lower A × β-reserve than patients without adverse cardiac events. In the former group, the CFR was ≥ 1.5 both pre- and post-PCI. CFR estimation by RTMCE can quantify myocardial perfusion in patients with ACS who underwent PCI. The parameters β-reserve and CFR combined might predict cardiac events on the follow-up.
authors.affiliation: Department of Image Center, Shanghai Xuhui Central Hospital, Shanghai, China.|Department of Echocardiography, Center of Medical Ultrasound, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Lixia
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Physiology and Pathophysiology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Chunmei
authors.initials: C
authors.lastname: Xia
authors.affiliation: Department of Echocardiography, Center of Medical Ultrasound, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Mu
authors.affiliation: Department of Echocardiography, Center of Medical Ultrasound, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Lina
authors.initials: L
authors.lastname: Guan
authors.affiliation: Department of Echocardiography, Center of Medical Ultrasound, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Chunmei
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Echocardiography, Center of Medical Ultrasound, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Tang
authors.affiliation: Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.|Image Diagnostics (CDPI) and Hospital Samaritano, Rio de Janeiro, Brazil.
authors.forename: Flavia Gomes
authors.initials: FG
authors.lastname: Verocai
authors.affiliation: Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Lea Mirian Barbosa da
authors.initials: LM
authors.lastname: Fonseca
authors.affiliation: Department of Radiology, The University of Chicago, Chicago, Illinois.|Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Ming Chi
authors.initials: MC
authors.lastname: Shih
mesh_terms: D003287:Contrast Media; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D010743:Phospholipids; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: coronary flow reserve; myocardial contrast echocardiography; myocardial perfusion; percutaneous coronary intervention; prognosis