Determination of Size and Transmural Extent of Acute Myocardial Infarction by Real-time Myocardial Perfusion Echocardiography: A Comparison with Magnetic Resonance Imaging

Trindade, Maria Luciana Zacarias Hannouche da; Caldas, Márcia Azevedo; Tsutsui, Jeane Mike; Rosário, Miguel Abraão; Rochitte, Carlos Eduardo; Nicolau, José Carlos; Ramires, José Antônio Franchini; Mathias, Wilson

doi:10.1016/j.echo.2006.08.022

Cited by 14 publications

(12 citation statements)

References 30 publications

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“…A normal stress MCE conferred a low cardiac event rate. On the other hand, patients with an abnormal MCE have higher cardiac event rate . Previous studies showed that no‐reflow extent was greater in patients with impaired CFR (<2.5) than in those with preserved CFR (≥ 2.5) .…”

Section: Discussionmentioning

confidence: 96%

Prognostic Value of Real Time Myocardial Contrast Echocardiography after Percutaneous Coronary Intervention

Yang

Xia

et al. 2015

Echocardiography

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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.

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Section: Discussionmentioning

confidence: 96%

Prognostic Value of Real Time Myocardial Contrast Echocardiography after Percutaneous Coronary Intervention

Yang

Xia

et al. 2015

Echocardiography

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“…It has been previously demonstrated that qualitative perfusion score indices of RT-MPE and CMR correlate well. 9,12 Previous studies evaluating the prediction of MACE by CMR and RT-MPE have been performed independently, without comparing the two modalities to each other. 17,18 It has been shown that poor perfusion score index after myocardial infarction predicts increased LV remodeling.…”

Section: Rt-mpe Both Infarct Mass By Cmr and Mean Blood Flow By Rt-mpementioning

confidence: 99%

“…We have recently shown that quantitative measures from RT‐MPE can effectively predict major adverse cardiac events following a STEMI . Qualitative assessment of myocardial perfusion by both CMR and RT‐MPE has been previously shown to predict functional outcomes following a myocardial infarction . However, there have been no trials to date comparing the ability of these modalities to predict adverse events following myocardial infarction using either quantitative or qualitative measures.…”

Section: Introductionmentioning

confidence: 99%

“…10 Qualitative assessment of myocardial perfusion by both CMR and RT-MPE has been previously shown to predict functional outcomes following a myocardial infarction. 9,11,12 However, there have been no trials to date comparing the ability of these modalities to predict adverse events following myocardial infarction using either quantitative or qualitative measures. The objective of this study was to compare quantitative and qualitative RT-MPE and CMR as predictors of major adverse cardiac events following STEMI revascularization.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of infarct mass by cardiac magnetic resonance and real time myocardial perfusion echocardiography as predictors of major adverse cardiac events following reperfusion for ST elevation myocardial infarction

et al. 2016

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Purpose: Infarct mass as assessed by myocardial-delayed enhancement imaging on cardiac magnetic resonance (CMR) and myocardial blood flow as assessed by real time myocardial perfusion echocardiography (RT-MPE) have been shown to predict adverse events following ST elevation myocardial infarction (STEMI). There has been no published comparison of quantitative assessment using these modalities as predictors of clinical outcomes to date. We compared RT-MPE with CMR for prediction of cardiac events in reperfused STEMI patients. Materials and Methods:Consecutive STEMI patients with early reperfusion were studied. RT-MPE and CMR were performed. Perfusion score indices (PSI RT-MPE and PSI CMR ) were calculated [sum of segmental perfusion scores/number of segments].CMR infarct mass (g) and RT-MPE myocardial blood flow (MBF dB/s) were quantified.Patients were followed for cardiac events (death, nonfatal MI, revascularization, angina, and heart failure).Results: All 27 patients (age 62±14; follow-up 3.5±2.6 years) had thrombolysis in myocardial infarction (TIMI) grade 3 flow of infarct vessel. Cardiac events occurred in 17 (63%). Cardiac event patients had higher PSI RT-MPE , PSI CMR , infarct mass, and lower MBF. PSI RT-MPE cutoff of 0.3 had an AUC of 0.856 (82% sensitivity, 70% specificity), while a PSI CMR cutoff of 0.2 had an AUC of 0.765 (76% sensitivity, 60% specificity).Infarct mass and MBF were independent predictors of cardiac events after adjusting for risk factors (hazard ratios: 20.9 [95% CI 1.8-256] P=. P=.01, respectively). Conclusions:Quantitative RT-MPE performed comparably to CMR for prediction of MACE in STEMI patients supporting a prognostic role for this noninvasive, bedside imaging method. K E Y W O R D Smajor adverse cardiac events, microvascular obstruction, outcomes research, perfusion imaging, prognosis, ST elevation myocardial infarction

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“…Investigating coronary microvascular function Lanza et al 7 49 59 MI Perfusion defect Standard echo Ballcells et al 50 30 MI Risk area/no-reflow Dobutamine stress echo Galiuto et al 51 24 MI No-reflow Standard echo Bolognese et al 52 124 MI No-reflow Standard echo Agati et al 53 12 MI No-reflow SPECT Janardhanan et al 54 42 MI No-reflow CMR Moir et al 55 90 CAD Stress perfusion defect Coronary angiography Galiuto et al 56 50 MI No-reflow Standard echo Trindade et al 57 20 MI No-reflow CMR Galiuto et al 58 110 MI No-reflow Coronary angiography Abdelmoneim et al 59 2 HM Vascularity Standard echo Hayat et al 60 83 CAD Stress perfusion defect SPECT Senior et al 61 662 CAD Stress perfusion defect SPECT Mansencal et al 62 31 HM Vascularity Histopathology Galiuto et al 63 20 Takotsubo Perfusion defects Standard echo CAD, stable coronary artery disease; CMR, cardiac magnetic resonance; HM, heart masses; MI, myocardial infarction; SPECT, single-photon emission tomography. tomography (MIBI-SPECT), 69 in detecting and quantifying the extent of no-reflow.…”

Section: Clinical Studiesmentioning

confidence: 99%

Methods to investigate coronary microvascular function in clinical practice

Lanza

Camici

Galiuto

et al. 2013

Journal of Cardiovascular Medicine

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A growing amount of data is increasingly showing the relevance of coronary microvascular dysfunction (CMVD) in several clinical contexts. This article reviews techniques and clinical investigations of the main noninvasive and invasive methods proposed to study coronary microcirculation and to identify CMVD in the presence of normal coronary arteries, also trying to provide indications for their application in clinical practice.

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Determination of Size and Transmural Extent of Acute Myocardial Infarction by Real-time Myocardial Perfusion Echocardiography: A Comparison with Magnetic Resonance Imaging

Cited by 14 publications

References 30 publications

Prognostic Value of Real Time Myocardial Contrast Echocardiography after Percutaneous Coronary Intervention

Prognostic Value of Real Time Myocardial Contrast Echocardiography after Percutaneous Coronary Intervention

A comparison of infarct mass by cardiac magnetic resonance and real time myocardial perfusion echocardiography as predictors of major adverse cardiac events following reperfusion for ST elevation myocardial infarction

Methods to investigate coronary microvascular function in clinical practice

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