Prediction of Transmural Extent of Infarction with Contrast Echocardiographically Derived Index of Myocardial Blood Flow and Myocardial Blood Volume Fraction: Comparison with Contrast-enhanced Magnetic Resonance Imaging

Eui Young Choi, Hye Sun Seo, Sungha Park, Hyun Joo Kim, Jeong Ah Ahn, Young Guk Ko, Byoung Wook Choi, Seok Min Kang, Donghoon Choi, Jong Won Ha, Se Joong Rim, Yangsoo Jang, Namsik Chung

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Abstract

Background: We sought to determine the accuracy of myocardial contrast echocardiography (MCE)-derived index of myocardial blood flow and myocardial blood volume fraction (MBVF) in predicting transmural extent of infarction and wall-motion recovery. Methods: Low and high mechanical index MCE and contrast-enhanced magnetic resonance imaging were performed 5 to 7 days after successful percutaneous revascularization in 30 patients with acute myocardial infarction and regional wall-motion change was assessed 3 months later. The index of myocardial blood flow was calculated as A × β (dB/s) using the equation y = A (1 - e-βt), which fits the replenishment curve of low mechanical index MCE. The MBVF (mL/100 g myocardium) was calculated as 100 × 10relative contrast intensity [CI]/10, using the relative CI by subtracting the cavity CI from the adjacent transmural CI using high mechanical index MCE. The contrast-enhanced magnetic resonance imaging-derived transmural extent of delayed hyperenhancement (DE) in 16 segments were measured and compared with corresponding MCE data. Results: Among 480 segments, 382 measurable segments were subdivided into 5 groups as follows: no DE, 1% to 25% DE, 26% to 50% DE, 51% to 75% DE, and 76% to 100% DE. An increment of the extent of DE was significantly related to a decrement of A × β (P < .001) and MBVF (P < .001). The optimal cut-off MBVF for predicting greater than 50% DE was 1.92 mL (sensitivity 82%, specificity 73%, P < .01), and persistently dysfunctional motion was 1.81 mL (sensitivity 74%, specificity 75%, P < .01). Conclusion: The MCE-derived A × β and MBVF can be effective predictors of transmural extent of infarction and wall-motion recovery in the reperfused acute myocardial infarction.

Original languageEnglish
Pages (from-to)1211-1219
Number of pages9
JournalJournal of the American Society of Echocardiography
Volume19
Issue number10
DOIs
Publication statusPublished - 2006 Oct

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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