Evaluation of myocardial viability after myocardial infarction
Northwick Park Hospital, Harrow, Middlesex, U.K.
* Correspondence: Dr Roxy Senior MD, DM, FRCP(Lond), Consultant Cardiologist and Director of Echocardiography, Northwick Park Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, U.K.
Abstract
Early after acute myocardial infarction in patients who are stable, it is important to assess myocardial viability for both prognostic and therapeutic reasons. Myocardial contrast echocardiography is a technique that utilizes intra-vascular injection of microbubbles. These microbubbles traverse the myocardial vasculature, producing opacification during echocardiography. The microbubbles remain entirely within the intra-vascular space, and their presence within any myocardial region denotes the status of microvascular perfusion within that region. It has recently been shown that microvascular perfusion parallels myocardial viability. Myocardial contrast echocardiography has the potential to evolve into a reliable and simple bedside technique for the assessment of viable myocardium after acute myocardial infarction.
Key Words: Contrast echocardiography myocardial viability real-time perfusion imaging
References
- Lee KS, Marwich TH, Cook SA, et al. Prognosis of patients with left ventricular dysfunction, with and without viable myocardium after myocardial infarction. Relative efficacy of medical therapy and revascularisation. Circulation. 1994;90:26872694
[Abstract/Free Full Text] - Dilsizian V, Bonow RO. Current diagnostic technique of assessing myocardial viability in hibernating and stunned myocardium. Circulation. 1993;87:120
[Free Full Text] - Senior R, Lahiri A. Value of dobutamine echocardiography for the assessment of myocardial viability for revascularisation. Congestive Heart Failure. 2001;7:3036
- Beller GA. Assessment of myocardial viability. Curr Opin Cardiol. 1997;12:459467[Web of Science][Medline]
- Udelson JE, Coleman PS, Metherall J, et al. Predicting recovery of severe regional ventricular dysfunction: comparison of resting scintigraphy with T1-201 and Tc-99m sestamibi. Circulation. 1994;89:25522561
[Abstract/Free Full Text] - Ragosta M, Camarano G, Kaul S, et al. Microvascular insights using myocardial contrast echocardiography. Circulation. 1994;89:25622569
[Abstract/Free Full Text] - Wei K, Jayaweera AR, Firoozan S, et al. Quantification of myocardial blood flow with ultrasound induced destruction of microbubbles administered as a constant venous infusion. Circulation. 1998;97:473483
[Abstract/Free Full Text] - Coulter S, Picard MH. Contrast echocardiography in coronary artery disease. Coron Artery Dis. 1998;9:391398[Web of Science][Medline]
- Vernon S, Kaul S, Powers ER, et al. Myocardial viability in patients with chronic coronary artery disease and previous myocardial infarction: comparison of myocardial contrast echocardiography and myocardial perfusion scintigraphy. Am Heart J. 1997;134:835840[CrossRef][Web of Science][Medline]
- Schneider M, Arditi M, Barrau M, et al. BR1: a new ultrasonographic contrast agent based on sulfur hexafluoride-filled microbubbles. Invest Radiol. 1995;30:451457[Web of Science][Medline]
- Senior R, Kaul S, Soman P, Lahiri A. Power Doppler harmonic imaging: a feasibility study of a new technique for the assessment of myocardial perfusion. Am Heart J. 2000;139:245251[Web of Science][Medline]
- Ito H, Tomooka T, Sakai N, et al. Lack of myocardial perfusion immediately after successful thrombolysis. A predictor of poor recovery of left ventricular function in anterior myocardial infarction. Circulation. 1992;85:16991705
[Abstract/Free Full Text] - Sabia PJ, Powers ER, Jayaweera AR, et al. Functional significance of collateral blood flow in patients with recent acute myocardial infarction. A study using myocardial contrast echocardiography. Circulation. 1992;85:20802089
[Abstract/Free Full Text] - Ragosta M, Camarano G, Kaul S, et al. Microvascular integrity indicates myocardial viability in patients with recent myocardial infarction: new insights using myocardial contrast echocardiography. Circulation. 1994;89:25622569
- Cherif JB, Narkiewicz-Jodko JB, Hawkins HK, et al. Myocardial contrast echocardiography: relation of collateral perfusion to extent of injury and severity of contractile dysfunction in a canine model of coronary thrombosis and reperfusion. J Am Coll Cardiol. 1995;26:537546[Abstract]
- Swinburn JMA, Lahiri A, Senior R. Intravenous myocardial contrast echocardiography predicts recovery of dysynergic myocardium early after acute myocardial infarction. J Am Coll Cardiol. 2001;38:1925
[Abstract/Free Full Text] - Galiuto L, Iliceto S. Myocardial contrast echocardiography in the evaluation of viable myocardium after acute myocardial infarction. Am J Cardiol. 1998;81:29G32G[CrossRef][Web of Science][Medline]
- Senior R, Swinburn J, Lahiri A. Enhanced prediction of myocardial viability by contrast echocardiography in dobutamine nonresponsive myocardium early after acute myocardial infarction. [abstract]Circulation. 2001;104:II333
- Schneider M. Characteristics of SonoVueTM. Echocardiography. 1999;16:743746[Web of Science][Medline]
- Swinburn J, Lahiri A, Senior R. Real time contrast echocardiography predicts contractile reserve early after myocardial infarction. [abstract]J Am Coll Cardiol. 2001;(suppl A):37
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