title: Scar Detection by Pulse-Cancellation Echocardiography: Validation by CMR in Patients With Recent STEMI.
abstract: This study sought to assess an echocardiographic approach (scar imaging echocardiography with ultrasound multipulse scheme [eSCAR]), based on existing multipulse ultrasound scheme, as a marker of myocardial scar in humans, compared with cardiac magnetic resonance assessing late gadolinium enhancement (CMR-LGE).
  
  
  
  The detection of myocardial scar impacts patient prognosis and management in coronary artery disease and other types of cardiac disease. The clinical experience with echocardiography suggests that the reflected ultrasound signal is often significantly enhanced in infarcted myocardial segments.
  
  
  
  Twenty patients with a recent ST-segment elevation myocardial infarction (STEMI) (cases) and 15 patients with absent CMR-LGE (negative controls) were imaged with both the eSCAR pulse-cancellation echocardiography and CMR-LGE to assess their potential association.
  
  
  
  Scar was detectable at CMR-LGE in 19 of 20 STEMI patients (91%), whereas all (100%) demonstrated eSCAR at echocardiography. In the 19 STEMI patients in whom CMR-LGE was detected, regional matching between eSCAR and CMR-LGE was total, although the segmental extent of detected scar was not always superimposable, particularly in the most apical segments, a region in which eSCAR demonstrated undersensitivity for the true extent of scar.
  
  
  
  A 2-dimensional multipulse echocardiography allows detection of myocardial scar, reliably matching the presence and site of CMR-LGE at 30 days after STEMI, or its absence in negative controls.
authors.affiliation: Parma University Hospital, Parma, Italy. Electronic address: ngaibazzi@gmail.com.
authors.forename: Nicola
authors.initials: N
authors.lastname: Gaibazzi
authors.affiliation: Parma University Hospital, Parma, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Bianconcini
authors.affiliation: UOC Cardiologia-ASL3 Ospedale San Francesco, Nuoro, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Marziliano
authors.affiliation: Mauriziano Hospital, Torino, Italy.
authors.forename: Iris
authors.initials: I
authors.lastname: Parrini
authors.affiliation: Mauriziano Hospital, Torino, Italy.
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Conte
authors.affiliation: Parma University Hospital, Parma, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Siniscalchi
authors.affiliation: Poliambulanza Hospital, Brescia, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Faden
authors.affiliation: Brescia Civili University Hospital, Brescia, Italy.
authors.forename: Pompilio
authors.initials: P
authors.lastname: Faggiano
authors.affiliation: Parma University Hospital, Parma, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Pigazzani
authors.affiliation: Parma University Hospital, Parma, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Grassi
authors.affiliation: Parma University Hospital, Parma, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Albertini
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002921:Cicatrix / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography; D004452:Echocardiography / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: cardiac magnetic resonance; echocardiography; late gadolinium enhancement; myocardial infarction; scar