Contrast echocardiography using intravenous octafluoropropane and real-time perfusion imaging predicts functional recovery following acute myocardial infarction.

Graham Scott Hillis, S. L. Mulvagh, M. Gunda, M. E. Hagen, G. S. Reeder, J. K. Oh

    Research output: Contribution to journalArticle

    30 Citations (Scopus)

    Abstract

    Akinesia after acute myocardial infarction (MI) may be reversible, secondary to stunning, or irreversible, as a result of extensive myocyte necrosis. Distinguishing these 2 entities soon after MI is difficult, but has important clinical implications. The current study assessed the use of intravenous myocardial contrast echocardiography (MCE) in this setting. A total of 35 patients were studied 2 (+/-1) days after an acute MI. Of these, 31 (91%) underwent myocardial revascularization. Perfusion was assessed using real-time MCE and an intravenous infusion of octafluoropropane microbubbles. Repeated echocardiograms were obtained 56 (+/-29) days later. Normal perfusion predicted functional recovery with a positive predictive value of 66% and a negative predictive value of 81%. The accuracy of the technique was superior in myocardial segments supplied by the left anterior descending coronary artery (positive and negative predictive value: 70% and 90%, respectively). in multivariable analysis, the mean MCE perfusion score in akinetic segments was the most powerful independent predictor of functional recovery (odds ratio 8.6, P =.02). These data suggest that real-time intravenous MCE is a useful predictor of functional recovery of akinetic myocardium after acute MI. (J Am Soc Echocardiogr 20031-16:638-45.).

    Original languageEnglish
    Pages (from-to)638-645
    Number of pages7
    JournalJournal of the American Society of Echocardiography
    Volume16
    DOIs
    Publication statusPublished - 2003

    Keywords

    • LEFT-VENTRICULAR FUNCTION
    • DOSE DOBUTAMINE ECHOCARDIOGRAPHY
    • PRIMARY CORONARY ANGIOPLASTY
    • HIBERNATING MYOCARDIUM
    • CONTRACTILE RESERVE
    • REPERFUSION
    • VIABILITY
    • DYSFUNCTION
    • NECROSIS
    • SALVAGE

    Cite this

    Contrast echocardiography using intravenous octafluoropropane and real-time perfusion imaging predicts functional recovery following acute myocardial infarction. / Hillis, Graham Scott; Mulvagh, S. L.; Gunda, M.; Hagen, M. E.; Reeder, G. S.; Oh, J. K.

    In: Journal of the American Society of Echocardiography, Vol. 16, 2003, p. 638-645.

    Research output: Contribution to journalArticle

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    abstract = "Akinesia after acute myocardial infarction (MI) may be reversible, secondary to stunning, or irreversible, as a result of extensive myocyte necrosis. Distinguishing these 2 entities soon after MI is difficult, but has important clinical implications. The current study assessed the use of intravenous myocardial contrast echocardiography (MCE) in this setting. A total of 35 patients were studied 2 (+/-1) days after an acute MI. Of these, 31 (91{\%}) underwent myocardial revascularization. Perfusion was assessed using real-time MCE and an intravenous infusion of octafluoropropane microbubbles. Repeated echocardiograms were obtained 56 (+/-29) days later. Normal perfusion predicted functional recovery with a positive predictive value of 66{\%} and a negative predictive value of 81{\%}. The accuracy of the technique was superior in myocardial segments supplied by the left anterior descending coronary artery (positive and negative predictive value: 70{\%} and 90{\%}, respectively). in multivariable analysis, the mean MCE perfusion score in akinetic segments was the most powerful independent predictor of functional recovery (odds ratio 8.6, P =.02). These data suggest that real-time intravenous MCE is a useful predictor of functional recovery of akinetic myocardium after acute MI. (J Am Soc Echocardiogr 20031-16:638-45.).",
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    AU - Mulvagh, S. L.

    AU - Gunda, M.

    AU - Hagen, M. E.

    AU - Reeder, G. S.

    AU - Oh, J. K.

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    N2 - Akinesia after acute myocardial infarction (MI) may be reversible, secondary to stunning, or irreversible, as a result of extensive myocyte necrosis. Distinguishing these 2 entities soon after MI is difficult, but has important clinical implications. The current study assessed the use of intravenous myocardial contrast echocardiography (MCE) in this setting. A total of 35 patients were studied 2 (+/-1) days after an acute MI. Of these, 31 (91%) underwent myocardial revascularization. Perfusion was assessed using real-time MCE and an intravenous infusion of octafluoropropane microbubbles. Repeated echocardiograms were obtained 56 (+/-29) days later. Normal perfusion predicted functional recovery with a positive predictive value of 66% and a negative predictive value of 81%. The accuracy of the technique was superior in myocardial segments supplied by the left anterior descending coronary artery (positive and negative predictive value: 70% and 90%, respectively). in multivariable analysis, the mean MCE perfusion score in akinetic segments was the most powerful independent predictor of functional recovery (odds ratio 8.6, P =.02). These data suggest that real-time intravenous MCE is a useful predictor of functional recovery of akinetic myocardium after acute MI. (J Am Soc Echocardiogr 20031-16:638-45.).

    AB - Akinesia after acute myocardial infarction (MI) may be reversible, secondary to stunning, or irreversible, as a result of extensive myocyte necrosis. Distinguishing these 2 entities soon after MI is difficult, but has important clinical implications. The current study assessed the use of intravenous myocardial contrast echocardiography (MCE) in this setting. A total of 35 patients were studied 2 (+/-1) days after an acute MI. Of these, 31 (91%) underwent myocardial revascularization. Perfusion was assessed using real-time MCE and an intravenous infusion of octafluoropropane microbubbles. Repeated echocardiograms were obtained 56 (+/-29) days later. Normal perfusion predicted functional recovery with a positive predictive value of 66% and a negative predictive value of 81%. The accuracy of the technique was superior in myocardial segments supplied by the left anterior descending coronary artery (positive and negative predictive value: 70% and 90%, respectively). in multivariable analysis, the mean MCE perfusion score in akinetic segments was the most powerful independent predictor of functional recovery (odds ratio 8.6, P =.02). These data suggest that real-time intravenous MCE is a useful predictor of functional recovery of akinetic myocardium after acute MI. (J Am Soc Echocardiogr 20031-16:638-45.).

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