Intravenous contrast echocardiography after myocardial infarction: relationship among residual myocardial perfusion, contractile reserve and long-term remodelling

Coser, Alessio; Franchi, Elena; Marini, Massimiliano; Cemin, Roberto; Benini, Adolfo; Beltrame, Federico; Marini, Alberto; Pascotto, Marco; Rognoni, Andrea; Ambrosio, Giuseppe; Marino, Paolo

doi:10.2459/jcm.0b013e32801da2bd

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…Our study did not confirm the value of earlier recognized predictors of left ventricular remodeling such as cardiac enzymes, electrocardiographic variables, or wall motion score index [27][28][29].…”

Section: Discussioncontrasting

confidence: 71%

“…Our study is, to our knowledge, the first one to study parameters defining maximum contrast perfusion corresponding to MBV, the rate of contrast perfusion in the myocardium, and the parameter corresponding to MBF for remodeling prediction. Recently, Coser et al [27] mentioned quantitative contrast echocardiography. His study population consisted of only 32 patients with anterior wall AMI.…”

Section: Discussionmentioning

confidence: 98%

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Prediction of left ventricular remodeling in patients with STEMI treated with primary PCI

Wita¹,

Filipecki²,

Lelek³

et al. 2011

Coronary Artery Disease

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The best predictors of remodeling in 6 months' observation have appeared to be lower left ventricular ejection fraction at discharge, poorer perfusion assessed angiographically (MBG scale), and the rate of signal intensity increase reflecting the mean bubble velocity of the myocardium by contrast as assessed by contrast echocardiography. Quantitative perfusion angiography independently has high predictive value for the development of remodeling in long-term follow-up.

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 98%

Prediction of left ventricular remodeling in patients with STEMI treated with primary PCI

Wita¹,

Filipecki²,

Lelek³

et al. 2011

Coronary Artery Disease

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show abstract

“…The extent and severity of myocardial perfusion defects (non-viable myocardium) after acute MI are also related to the development of LV dilatation (remodelling) over time 58 59 60 61 62. In the Acute Myocardial Infarction Contrast Imaging (AMICI) study, Galiuto and coworkers evaluated 110 patients with first successfully reperfused STEMI 61.…”

Section: Contrast Echocardiographymentioning

confidence: 99%

Prognostic value of echocardiography after acute myocardial infarction

Mollema

Nucifora

Bax

2009

Heart

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Echocardiography is useful for risk stratification and assessment of prognosis after myocardial infarction, which is the focus of this review. Various traditional echocardiographic parameters have been shown to provide prognostic information, such as left ventricular volumes and ejection fraction, wall motion score index, mitral regurgitation and left atrial volume. The introduction of tissue Doppler imaging and speckle-tracking strain imaging has resulted in additional prognostic parameters, such as left ventricular strain (rate) and dyssynchrony. Also, (myocardial) contrast echocardiography provides valuable information, particularly about myocardial perfusion (as a marker of myocardial viability), which is strongly related to prognosis after myocardial infarction. Stress echocardiography provides information on ischaemia and viability, coronary flow reserve can be obtained by Doppler imaging of the coronary arteries, and finally, three-dimensional echocardiography provides optimal information on left ventricular volumes, function and sphericity, which are also important for long-term outcome.

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“…Microvascular dysfunction in the non-infarcted myocardium is representative of more extensive necrosis and deterioration of cardiac function. Several possible mechanisms have been proposed,15,16,17,18,19 including impairment of endothelium-dependent dilation, sharing of microvascular systems between the infarcted and non-infarcted myocardium, and vasoconstriction mediated by systemic or local neurohumoral reflexes. Furthermore, cardiospecific overexpression of the angiotensin II type 1 receptor and a decrease in microvessel density in the non-infarcted myocardium have also been observed, which lead to microvascular dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Coronary Flow Reserve in the Remote Myocardium Predicts Left Ventricular Remodeling Following Acute Myocardial Infarction

et al. 2014

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PurposeCoronary flow reserve (CFR) in the non-infarcted myocardium is often impaired following acute myocardial infarction (AMI). However, the clinical significance of CFR in the non-infarcted myocardium is not fully understood. The objective of the present study was to assess whether a relationship exists between CFR and left ventricular remodeling following AMI.Materials and MethodsWe enrolled 18 consecutive patients undergoing coronary intervention. Heart function was analyzed using real-time myocardial contrast echocardiography at one week and six months after coronary angioplasty. Ten subjects were enrolled as the control group and were examined using the same method at the same time to assess CFR. Cardiac troponin I (cTnI) levels were routinely analyzed to estimate peak concentration.ResultsCFR was 1.55±0.11 in the infarcted zone and 2.05±0.31 in the remote zone (p<0.01) at one week following AMI. According to CFR values in the remote zone, all patients were divided into two groups: Group I (CFR <2.05) and Group II (CFR >2.05). The levels of cTnI were higher in Group I compared to Group II on admission (36.40 vs. 21.38, p<0.05). Furthermore, left ventricular end diastolic volume was higher in Group I compared to Group II at six months following coronary angioplasty.ConclusionMicrovascular dysfunction is commonly observed in the remote myocardium. The CFR value accurately predicts adverse ventricular remodeling following AMI.

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Intravenous contrast echocardiography after myocardial infarction: relationship among residual myocardial perfusion, contractile reserve and long-term remodelling

Abstract: Unlike inotropic reserve, residual myocardial blood volume in the dysfunctioning muscle, as assessed by predischarge quantitative intravenous MCE, has the potential to modulate remodelling in patients who suffered an anterior MI.

Cited by 5 publications

References 34 publications

Prediction of left ventricular remodeling in patients with STEMI treated with primary PCI

Prediction of left ventricular remodeling in patients with STEMI treated with primary PCI

Prognostic value of echocardiography after acute myocardial infarction

Coronary Flow Reserve in the Remote Myocardium Predicts Left Ventricular Remodeling Following Acute Myocardial Infarction

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