Evaluation of the Left Ventricular Remodeling in Patients with Myocardial Infarction after Revascularization with Intravenous Real-time Myocardial Contrast Echocardiography
- Author:
BI XIAOJUN
1
;
DENG YOUBIN
;
SHENTU WEIHUI
;
XIONG LI
;
ZHANG YUN
;
YU FEN
;
HUANG RUNQING
Author Information
1. 华中科技大学同济医学院附属同济医院
- Keywords:
real-time myocardial contrast echocardiography;
myocardial infarction;
left ventricular remodeling;
revascularization
- From:
Journal of Huazhong University of Science and Technology (Medical Sciences)
2008;28(3):287-290
- CountryChina
- Language:Chinese
-
Abstract:
In order to evaluate the left ventricular remodeling in patients with myocardial infarction after revascularization with intravenous real-time myocardial contrast echocardiography (RT-MCE), intravenous RT-MCE was performed on 20 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions: homogeneous opacification=1; partial or reduced opaciflcation or subendocardial contrast defect=2; constrast defect=3. Myocardial perfusion score index (MPSI) was calculated by dividing the total sum of contrast score by the total number of segments with abnormal wall motion. Twenty patients were classified into 2 groups according to the MPSI: MPSI≤1.5 as good myocardial perfusion, MPSI>1.5 as poor myocardial perfusion. To assess the left ventricular remodeling, the following comparisons were carried out: (1) Comparisons of left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) before and 3 months after revascularization in two groups; (2) Comparisons of LVEF, LVESV and LVEDV pre-revascularization between two groups and comparisons of these 3 months post-revascularization between two groups; (3) Comparisons of the differences in LVEF, LVESV and LVEDV between 3 months post-and pre-revascularization (△LVEF, △LVESV and △LVEDV) between two groups; (4) The linear regression analysis between △LVEF, △LVESV, △LVEDV and MPSI. The results showed that the LVEF obtained 3 months after revascularization in patients with MPSI>1.5 was obviously lower than that in those with MPSI≤1.5. The LVEDV obtained 3 months post-revascularization in patients with MPSI>1.5 was obviously larger than that in those with MPSI≤1.5 (P=0.002 and 0.04). The differences in ΔLVEF and ΔLVEDV between patients with MPSI>1.5 and those with MPSI≤1.5 were significant (P=0.002 and 0.001, respectively). Linear regression analysis revealed that MPSI had a negative correlation with △LVEF and a positive correlation with ΔLVESV, ΔLVEDV (P=0.004,0.008, and 0.016, respectively). It was concluded that RT-MCE could accurately evaluate the left ventricular remodeling in patients with myocardial infarction after revascularization.
