Value of transthoracic two-dimensional echocardiography in predicting viability in patients with healed Q-wave anterior wall myocardial infarction

Faletra, Francesco F.; Crivellaro, Wilma; Pirelli, Salvatore; Parodi, Oberdan; Chiara, Francesca De; Cipriani, Manlio; Corno, Roberto; Pezzano, Antonio

doi:10.1016/s0002-9149(99)80284-7

Cited by 34 publications

(17 citation statements)

References 21 publications

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“…16 Segments which displayed akinesis or dyskinesis in combination with a disproportionate local wall thinning and hyperreflectivity in comparison with adjacent contractile segments were scored as "scarred." 17 For offline deformation imaging, additional single wall images of the septum and lateral wall were prospectively acquired from the standard apical views at 51 to 109 frames per second. Timing of mitral and aortic valve opening and closure, as derived from Doppler flow patterns over the left-sided valves, served as cardiac event timing markers.…”

Section: Echocardiographic Protocolmentioning

confidence: 99%

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Septal Deformation Patterns Delineate Mechanical Dyssynchrony and Regional Differences in Contractility

Leenders

Lumens

Cramer

et al. 2012

Circ: Heart Failure

133

123

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Background-Response to cardiac resynchronization therapy depends both on dyssynchrony and (regional) contractility.We hypothesized that septal deformation can be used to infer integrated information on dyssynchrony and regional contractility, and thereby predict cardiac resynchronization therapy response. Methods and Results-In 132 cardiac resynchronization therapy candidates with left bundle branch block (LBBB)-like electrocardiogram morphology (left ventricular ejection fraction 19Ϯ6%; QRS width 170Ϯ23 ms), longitudinal septal strain was assessed by speckle tracking echocardiography. To investigate the effects of dyssynchronous activation and differences in septal and left ventricular free wall contractility on septal deformation pattern, we used the CircAdapt computer model of the human heart and circulation. In the patients, 3 characteristic septal deformation patterns were identified: LBBB-1ϭdouble-peaked systolic shortening (nϭ28); LBBB-2ϭearly systolic shortening followed by prominent systolic stretching (nϭ34); and LBBB-3ϭpseudonormal shortening with less pronounced late systolic stretch (nϭ70). LBBB-3 revealed more scar (

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Section: Echocardiographic Protocolmentioning

confidence: 99%

“…Although this is an accepted approach, 17 the use of late gadolinium-enhanced magnetic resonance imaging might have revealed additional areas of (more subtle) scarring.…”

Section: Limitationsmentioning

confidence: 99%

Septal Deformation Patterns Delineate Mechanical Dyssynchrony and Regional Differences in Contractility

Leenders

Lumens

Cramer

et al. 2012

Circ: Heart Failure

133

123

View full text Add to dashboard Cite

show abstract

“…In addition, 98% of the segments which improved intra-operatively, showed a preserved diastolic wall thickness, and only 24% of those failing to improve after surgery had a preserved diastolic wall thickness. Thus, estimation of the diastolic wall thickness can be considered a sensitive predictor of viability and functional recovery after revascularization [28] , although its specificity is poor. However, the negative predictive value of reduced diastolic wall thickness (<5 mm), was very high (97-100%), indicating that if diastolic wall thickness is <5 mm, additional testing and revascularization may not be indicated in all patients.…”

Section: Baseline Echocardiography and Dobutamine Echocardiographymentioning

confidence: 99%

Sensitivity, specificity, and predictive accuracies of non-invasive tests, singly and in combination, for diagnosis of hibernating myocardium

LaCanna

Rahimtoola

Visioli

et al. 2000

European Heart Journal

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Objective To determine the best test(s) for predicting functional recovery of hibernating myocardium after reperfusion.Methods A prospective study to compare echocardiographic left ventricular diastolic wall thickness (d5 mm), low-dose dobutamine echocardiography and restredistribution thallium-201 scintigraphy, alone and in combination, for predicting recovery of left ventricular akinesis after surgical revascularization.Results Twenty-eight consecutive patients aged 58 9 years were studied. Of the 448 left ventricular segments, 263 were akinetic at rest; 230/263 (87%) had wall thickness d5 mm, 135 (51%) had a positive response and 175 (66·5%) were graded viable on thallium. Of akinetic segments 61% improved after surgery. Left ventricular score decreased from 2·3 0·4 to 1·8 0·4 (P<0·01) and ejection fraction increased from 27 10 to 37 14% (P<0·01). For predicting results at 1 year, diastolic wall thickness had a sensitivity and a predictive accuracy of a negative test of 100% but a specificity of 28% and predictive accuracy of a positive test of 61%. The addition of dobutamine echocardiography or thallium-201 improved the predictive accuracy of a positive test to 76% and 69%, respectively; the addition of both tests was not of greater benefit than that of a single test.Conclusions Diastolic wall thickness <5 mm on echocardiography was the best simple and single predictor of non-recovery of left ventricular dysfunction. The addition of dobutamine echocardiography or thallium-201, but not both, was the best solution for predicting recovery of left ventricular dysfunction. In times of limited resources, these findings are important from a clinical point of view.

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“…This is in agreement with earlier reports, which also demonstrated that the presence of this magnitude of interstitial fibrosis is associated with irreversible myocardial dysfunction. 2,3 We suggest, therefore, that myocardial segments with these characteristics be removed from the analysis because they represent irreversibly damaged scar tissue rather than hibernating myocardium.…”

Section: To the Editormentioning

confidence: 99%

“…2 These were all reasonable measures taken to avoid including predominantly scar segments. Furthermore, these inclusion criteria assured the inclusion of segments that resemble, to a great extent, the majority of segments in which myocardial viability is to be determined.…”

Section: Responsementioning

confidence: 99%

Relation of Contractile Reserve of Hibernating Myocardium to Myocardial Structure in Humans

Pagano

Camici

2000

Circulation

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Value of transthoracic two-dimensional echocardiography in predicting viability in patients with healed Q-wave anterior wall myocardial infarction

Cited by 34 publications

References 21 publications

Septal Deformation Patterns Delineate Mechanical Dyssynchrony and Regional Differences in Contractility

Septal Deformation Patterns Delineate Mechanical Dyssynchrony and Regional Differences in Contractility

Sensitivity, specificity, and predictive accuracies of non-invasive tests, singly and in combination, for diagnosis of hibernating myocardium

Relation of Contractile Reserve of Hibernating Myocardium to Myocardial Structure in Humans

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