Prognostic Value of Real Time Myocardial Contrast Echocardiography after Percutaneous Coronary Intervention.

Yang, Lixia; Xia, Chunmei; Mu, Yuming; Guan, Lina; Wang, Chunmei; Tang, Qi; Verocai, Flavia Gomes; Fonseca, Lea Mirian Barbosa da; Shih, Ming Chi

Real time myocardial contrast echocardiography (RTMCE) is a cost-effective and simple method to quantify coronary flow reserve ( CFR). We aimed to determine the value of RTMCE to predict cardiac events after percutaneous coronary intervention ( PCI). We have studied myocardial blood volume (A), velocity ( β), flow indexes ( MBF, A × β), and vasodilator reserve (stress-to-rest ratios) in 36 patients with acute coronary syndrome ( ACS) who underwent PCI. CFR ( MBF at stress/ MBF at rest) was calculated for each patient. Perfusion scores were used for visual interpretation by MCE and correlation with TIMI flow grade. In qualitative RTMCE assessment, post- PCI visual perfusion scores were higher than pre- PCI (Z = −7.26, P < 0.01). Among 271 arteries with TIMI flow grade 3 post- PCI, 72 (36%) did not reach visual perfusion score 1. The β- and A × β-reserve of the abnormal segments supplied by obstructed arteries increased after PCI comparing to pre- PCI values (P < 0.01). Patients with adverse cardiac events had significantly lower β- and lower A × β-reserve than patients without adverse cardiac events. In the former group, the CFR was ≥ 1.5 both pre- and post- PCI. CFR estimation by RTMCE can quantify myocardial perfusion in patients with ACS who underwent PCI. The parameters β-reserve and CFR combined might predict cardiac events on the follow-up.

CHINA; MYOCARDIAL infarction diagnosis; ACUTE coronary syndrome; ACADEMIC medical centers; ADENOSINES; ANALYSIS of variance; BLOOD circulation; BLOOD flow measurement; CONFIDENCE intervals; CORONARY circulation; ECHOCARDIOGRAPHY; LEFT heart ventricle; HEART function tests; HEMODYNAMICS; LONGITUDINAL method; MYOCARDIAL revascularization; PROBABILITY theory; RESEARCH evaluation; RESEARCH funding; STATISTICS; T-test (Statistics); TRANSLUMINAL angioplasty; DATA analysis; TREATMENT effectiveness; PRE-tests & post-tests; INTER-observer reliability; CONTRAST media; DATA analysis software; DESCRIPTIVE statistics; CORONARY angiography; ODDS ratio; INTRACLASS correlation; DIAGNOSIS

Echocardiography, 2016, Vol 33, Issue 3, p421

0742-2822

Academic Journal

10.1111/echo.13061