Relationship between myocardial perfusion with myocardial contrast echocardiography and function early after acute myocardial infarction for the prediction of late recovery of function

Girish Dwivedi, Rajesh Janardhanan, Sajad A. Hayat, Tiong K. Lim, Kim Greaves, Roxy Senior

    Research output: Contribution to journalArticle

    6 Citations (Scopus)

    Abstract

    Background: Following ST elevation acute myocardial infarction (STEMI) and reperfusion therapy, there are often persistent wall thickening (WT) abnormalities and perfusion defects due to variable degree of myocardial stunning and necrosis. We hypothesised that following STEMI and reperfusion therapy, the extent of residual perfusion assessed by myocardial contrast echocardiography (MCE) and not the extent of WT abnormalities would predict subsequent global recovery of left ventricular (LV) function.

    Methods: Accordingly, 112 patients with STEMI underwent simultaneous assessment of WT abnormality and perfusion using MCE 7 +/- 2 days after AMI and reperfusion therapy. Both WT and perfusion were scored on a 16 segment LV model. Contrast perfusion index (CPI), and global LV function were calculated. Echocardiography was repeated 12 weeks after reperfusion to assess recovery of LV function.

    Results: Of the 112 patients recruited, follow up echocardiography 12 weeks after reperfusion was available in 98 patients. CPI was significantly higher (p<0.0001) in the 66 patients, who showed late recovery of LV function (1.67 +/- 0.27) compared to those who did not show recovery of function (1.25 +/- 0.04). No significant difference was noted in the indices of baseline LV function in patients with (1.67 +/- 0.32) and without (1.80 +/- 0.36) recovery of LV function. The multivariable predictors of late recovery of function were MCE (p=0.02), absence of diabetes (p=0.02) and lower peak creatine kinase (p=0.01).

    Conclusion: The extent of residual contrast perfusion and not WT abnormalities predicts late recovery of global LV function after acute myocardial infarction and reperfusion therapy. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

    Original languageEnglish
    Pages (from-to)169-174
    Number of pages6
    JournalInternational journal of cardiology
    Volume140
    Issue number2
    DOIs
    Publication statusPublished - 15 Apr 2010

    Keywords

    • Acute myocardial infarction
    • Recovery of function
    • Myocardial contrast echocardiography
    • Wall thickening
    • Perfusion
    • Acute coronary occlusion
    • Blood flow
    • Collateral flow
    • Risk area
    • Size
    • Ischemia
    • Extent
    • Necrosis
    • DOG

    Cite this

    Dwivedi, Girish ; Janardhanan, Rajesh ; Hayat, Sajad A. ; Lim, Tiong K. ; Greaves, Kim ; Senior, Roxy. / Relationship between myocardial perfusion with myocardial contrast echocardiography and function early after acute myocardial infarction for the prediction of late recovery of function. In: International journal of cardiology. 2010 ; Vol. 140, No. 2. pp. 169-174.
    @article{7bdd89041048438cbfe22bb02ad8808b,
    title = "Relationship between myocardial perfusion with myocardial contrast echocardiography and function early after acute myocardial infarction for the prediction of late recovery of function",
    abstract = "Background: Following ST elevation acute myocardial infarction (STEMI) and reperfusion therapy, there are often persistent wall thickening (WT) abnormalities and perfusion defects due to variable degree of myocardial stunning and necrosis. We hypothesised that following STEMI and reperfusion therapy, the extent of residual perfusion assessed by myocardial contrast echocardiography (MCE) and not the extent of WT abnormalities would predict subsequent global recovery of left ventricular (LV) function.Methods: Accordingly, 112 patients with STEMI underwent simultaneous assessment of WT abnormality and perfusion using MCE 7 +/- 2 days after AMI and reperfusion therapy. Both WT and perfusion were scored on a 16 segment LV model. Contrast perfusion index (CPI), and global LV function were calculated. Echocardiography was repeated 12 weeks after reperfusion to assess recovery of LV function.Results: Of the 112 patients recruited, follow up echocardiography 12 weeks after reperfusion was available in 98 patients. CPI was significantly higher (p<0.0001) in the 66 patients, who showed late recovery of LV function (1.67 +/- 0.27) compared to those who did not show recovery of function (1.25 +/- 0.04). No significant difference was noted in the indices of baseline LV function in patients with (1.67 +/- 0.32) and without (1.80 +/- 0.36) recovery of LV function. The multivariable predictors of late recovery of function were MCE (p=0.02), absence of diabetes (p=0.02) and lower peak creatine kinase (p=0.01).Conclusion: The extent of residual contrast perfusion and not WT abnormalities predicts late recovery of global LV function after acute myocardial infarction and reperfusion therapy. (C) 2008 Elsevier Ireland Ltd. All rights reserved.",
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    author = "Girish Dwivedi and Rajesh Janardhanan and Hayat, {Sajad A.} and Lim, {Tiong K.} and Kim Greaves and Roxy Senior",
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    Relationship between myocardial perfusion with myocardial contrast echocardiography and function early after acute myocardial infarction for the prediction of late recovery of function. / Dwivedi, Girish; Janardhanan, Rajesh; Hayat, Sajad A.; Lim, Tiong K.; Greaves, Kim; Senior, Roxy.

    In: International journal of cardiology, Vol. 140, No. 2, 15.04.2010, p. 169-174.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Relationship between myocardial perfusion with myocardial contrast echocardiography and function early after acute myocardial infarction for the prediction of late recovery of function

    AU - Dwivedi, Girish

    AU - Janardhanan, Rajesh

    AU - Hayat, Sajad A.

    AU - Lim, Tiong K.

    AU - Greaves, Kim

    AU - Senior, Roxy

    PY - 2010/4/15

    Y1 - 2010/4/15

    N2 - Background: Following ST elevation acute myocardial infarction (STEMI) and reperfusion therapy, there are often persistent wall thickening (WT) abnormalities and perfusion defects due to variable degree of myocardial stunning and necrosis. We hypothesised that following STEMI and reperfusion therapy, the extent of residual perfusion assessed by myocardial contrast echocardiography (MCE) and not the extent of WT abnormalities would predict subsequent global recovery of left ventricular (LV) function.Methods: Accordingly, 112 patients with STEMI underwent simultaneous assessment of WT abnormality and perfusion using MCE 7 +/- 2 days after AMI and reperfusion therapy. Both WT and perfusion were scored on a 16 segment LV model. Contrast perfusion index (CPI), and global LV function were calculated. Echocardiography was repeated 12 weeks after reperfusion to assess recovery of LV function.Results: Of the 112 patients recruited, follow up echocardiography 12 weeks after reperfusion was available in 98 patients. CPI was significantly higher (p<0.0001) in the 66 patients, who showed late recovery of LV function (1.67 +/- 0.27) compared to those who did not show recovery of function (1.25 +/- 0.04). No significant difference was noted in the indices of baseline LV function in patients with (1.67 +/- 0.32) and without (1.80 +/- 0.36) recovery of LV function. The multivariable predictors of late recovery of function were MCE (p=0.02), absence of diabetes (p=0.02) and lower peak creatine kinase (p=0.01).Conclusion: The extent of residual contrast perfusion and not WT abnormalities predicts late recovery of global LV function after acute myocardial infarction and reperfusion therapy. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

    AB - Background: Following ST elevation acute myocardial infarction (STEMI) and reperfusion therapy, there are often persistent wall thickening (WT) abnormalities and perfusion defects due to variable degree of myocardial stunning and necrosis. We hypothesised that following STEMI and reperfusion therapy, the extent of residual perfusion assessed by myocardial contrast echocardiography (MCE) and not the extent of WT abnormalities would predict subsequent global recovery of left ventricular (LV) function.Methods: Accordingly, 112 patients with STEMI underwent simultaneous assessment of WT abnormality and perfusion using MCE 7 +/- 2 days after AMI and reperfusion therapy. Both WT and perfusion were scored on a 16 segment LV model. Contrast perfusion index (CPI), and global LV function were calculated. Echocardiography was repeated 12 weeks after reperfusion to assess recovery of LV function.Results: Of the 112 patients recruited, follow up echocardiography 12 weeks after reperfusion was available in 98 patients. CPI was significantly higher (p<0.0001) in the 66 patients, who showed late recovery of LV function (1.67 +/- 0.27) compared to those who did not show recovery of function (1.25 +/- 0.04). No significant difference was noted in the indices of baseline LV function in patients with (1.67 +/- 0.32) and without (1.80 +/- 0.36) recovery of LV function. The multivariable predictors of late recovery of function were MCE (p=0.02), absence of diabetes (p=0.02) and lower peak creatine kinase (p=0.01).Conclusion: The extent of residual contrast perfusion and not WT abnormalities predicts late recovery of global LV function after acute myocardial infarction and reperfusion therapy. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

    KW - Acute myocardial infarction

    KW - Recovery of function

    KW - Myocardial contrast echocardiography

    KW - Wall thickening

    KW - Perfusion

    KW - Acute coronary occlusion

    KW - Blood flow

    KW - Collateral flow

    KW - Risk area

    KW - Size

    KW - Ischemia

    KW - Extent

    KW - Necrosis

    KW - DOG

    U2 - 10.1016/j.ijcard.2008.11.052

    DO - 10.1016/j.ijcard.2008.11.052

    M3 - Article

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    SP - 169

    EP - 174

    JO - International journal of cardiology

    JF - International journal of cardiology

    SN - 0167-5273

    IS - 2

    ER -