Evaluation of viable myocardium in patients with chronic total coronary occlusion by real-time myocardial contrast echocardiography
10.3760/cma.j.issn.1001-4497.2013.10.008
- VernacularTitle:实时心肌超声造影检测冠状动脉慢性完全闭塞患者存活心肌
- Author:
Lei XU
;
Chang LIU
;
Chunhong XIU
;
Zonghong LIU
;
Xigang XIAO
;
Jingxia SHEN
;
Hongyu LIU
- Publication Type:Journal Article
- Keywords:
Coronary arteriosclerosis;
Myocardium;
Coronary artery bypass,off-pump;
Angiocardiography;
Real-time myocardial contrast echocardiography
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2013;29(10):600-603
- CountryChina
- Language:Chinese
-
Abstract:
Objective Analysis of myocardial microvascular perfusion in patients with chronic total coronary occlusion (CTO) who underwent a coronary artery bypass graft (CABG) use real-time myocardial contrast echocardiography (RTMCE),to provide an effective method of detecting viable myocardium and a reference for the choice of CABG indications.Methods Twenty-seven patients with CTO underwent RTMCE 1 week before CABG,they underwent follow-up echocardiography and coronary artery 256-slice multislice computed tomography aagiography 1 year after CABG.Myocardial viability was defined as a postoperative ultrasound wall motion significantly improved ≥ 1 point.Semi-quantitative analysis of contrast images,myocardial viability was defined as myocardial perfusion score ≤ 2 points.Viable myocardium by quantitative assessment of myocardial blood flow (MBF) was determined by analyses of receiver-operating characteristic (ROC) curves.Results Patients with LVEF increased significantly after CABG (P ＜ 0.01),Of 259 segments with wall motion abnormality,149 (58％) showed wall motion significantly improved ≥ 1 point after CABG,considered viable myocardium,110 (42％) were not observed in wall motion improved,considered to be non-viable.The viable myocardial segments were significantly greater than non-viable myocardial segments in A,β,A × β value (P ＜ 0.01).Compared with the semi-quantitative analysis,quantitative analysis of MBF increased the sensitivity and accuracy of RTMCE for detecting viable myocardium (P ＜ 0.05).Conclusion RTMCE could accurately assess myocardial viability and provide a strong reference for clinical decision making and judging prognosis.
