Key result
Harmonic power Doppler imaging demonstrated significantly higher pixel intensity ratios during hyperaemia in patients with myocardial viability compared to those without (0.72 vs 0.40, P=0.003).
Why the study?
Does harmonic power Doppler imaging with intravenous Levovist accurately assess myocardial viability compared to 201Tl-SPECT and coronary flow velocity reserve in patients with anterior myocardial infarction?
Observational (n=23)
Does harmonic power Doppler imaging with intravenous Levovist accurately assess myocardial viability compared to 201Tl-SPECT and coronary flow velocity reserve 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 corresponds well with myocardial viability by 201Tl-SPECT and microcirculation evaluation by coronary flow velocity reserve.
May aid viability assessment post-anterior MI; leaves open prospective validation versus 201Tl-SPECT before clinical use.
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 assessed by 201Tl-SPECT vs. No myocardial viability was evaluated on Peak colour pixel intensity ratios of the risk area to the control area during hyperaemia (p=0.003). Harmonic power Doppler imaging demonstrated significantly higher pixel intensity ratios during hyperaemia in patients with myocardial viability compared to those without (0.72 vs 0.40, P=0.003).
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