Key result
In patients with anterior myocardial infarction, pixel intensity ratios during hyperaemia were significantly higher in those with myocardial viability compared to those without (0.72 vs 0.40, P=0.003).
Why the study?
Does myocardial contrast echocardiography with harmonic power Doppler imaging correlate with (201)Tl-SPECT and coronary flow velocity reserve for assessing myocardial viability in patients with anterior myocardial infarction?
Observational (n=23)
Does myocardial contrast echocardiography with harmonic power Doppler imaging correlate with (201)Tl-SPECT and coronary flow velocity reserve for assessing myocardial viability in patients with anterior myocardial infarction?
Absolute Event Rate: 0.72% vs 0.4%
p-value: p=0.003
Quantitative assessment of microvascular integrity by harmonic power Doppler imaging with intravenous contrast corresponds well with myocardial viability assessed by 201Tl-SPECT and microcirculation evaluated by coronary flow velocity reserve.
Supports contrast echocardiography for viability assessment in anterior MI; leaves open prospective validation before clinical adoption.
BACKGROUND: Intravenous myocardial contrast echocardiography with harmonic power Doppler imaging is a novel technique for assessing myocardial perfusion. AIMS: The aim of this study was to quantitatively assess myocardial perfusion by harmonic power Doppler imaging in patients with a previous myocardial infarction and compare myocardial contrast echocardiography results with myocardial viability evaluated by thallium-201 single-photon emission computed tomography ((201)Tl-SPECT) and the results of Doppler flow measurement of coronary flow velocity reserve. METHODS: Twenty-three patients with anterior myocardial infarction who were scheduled for adenosine stress (201)Tl-SPECT underwent myocardial contrast echocardiography with harmonic power Doppler imaging. Harmonic power Doppler imaging was performed at rest and during adenosine infusion (0.15 mg/kg/min) using an intravenous infusion of Levovist. The peak colour pixel intensity ratios of the risk area to the control area were used for quantitative analysis of myocardial perfusion by harmonic power Doppler imaging. Coronary blood flow velocity was measured using Doppler-tipped guidewire in the distal portion of left anterior descending artery and coronary flow velocity reserve was calculated. RESULTS: In patients with myocardial viability assessed by (201)Tl-SPECT, pixel intensity ratios both at rest and during hyperaemia were significantly higher compared with those in patients without myocardial viability (at rest: 0.62 +/- 0.28 vs 0.37 +/- 0.17, P=0.038, during hyperaemia 0.72 +/- 0.19 vs 0.40 +/- 0.18, P=0.003). Coronary flow velocity reserve was significantly different between two groups (2.35 +/- 0.43 vs 1.49 +/- 0.53, P <0.01). CONCLUSIONS: Quantitative assessment of microvascular integrity by harmonic power Doppler imaging corresponds to the evaluation of the microcirculation by coronary flow velocity reserve.
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Tani et al. (2002) conducted an observational in Anterior myocardial infarction (n=23). Myocardial viability on 201Tl-SPECT vs. No myocardial viability on 201Tl-SPECT was evaluated on Pixel intensity ratio during hyperaemia (p=0.003). In patients with anterior myocardial infarction, pixel intensity ratios during hyperaemia were significantly higher in those with myocardial viability compared to those without (0.72 vs 0.40, P=0.003).
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