Contrast Echocardiography Using Intravenous Octafluoropropane and Real-time Perfusion Imaging Predicts Functional Recovery after Acute Myocardial Infarction

Graham S. Hillis, Sharon L. Mulvagh, Madhavi Gunda, Mary E. Hagen, Guy S. Reeder, Jae K. Oh

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Akinesia after acute myocardial infarction (MI) may be reversible, secondary to stunning, or irreversible, as a result of extensive myocyte necrosis. Distinguishing these 2 entities soon after MI is difficult, but has important clinical implications. The current study assessed the use of intravenous myocardial contrast echocardiography (MCE) in this setting. A total of 35 patients were studied 2 (± 1) days after an acute MI. Of these, 31 (91%) underwent myocardial revascularization. Perfusion was assessed using real-time MCE and an intravenous infusion of octafluoropropane microbubbles. Repeated echocardiograms were obtained 56 (± 29) days later. Normal perfusion predicted functional recovery with a positive predictive value of 66% and a negative predictive value of 81%. The accuracy of the technique was superior in myocardial segments supplied by the left anterior descending coronary artery (positive and negative predictive value: 70% and 90%, respectively). In multivariable analysis, the mean MCE perfusion score in akinetic segments was the most powerful independent predictor of functional recovery (odds ratio 8.6, P = .02). These data suggest that real-time intravenous MCE is a useful predictor of functional recovery of akinetic myocardium after acute MI.

Original languageEnglish (US)
Pages (from-to)638-645
Number of pages8
JournalJournal of the American Society of Echocardiography
Volume16
Issue number6
DOIs
StatePublished - Jun 2003

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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