Comparison between myocardial contrast echocardiography and single-photon emission computed tomography for predicting transmurality of acute myocardial infarction.
Am J Cardiol
Contrast-enhanced cardiovascular magnetic resonance imaging (CMR) has been shown to accurately assess transmural extent of infarction, which is an excellent predictor of long-term improvement in contractile function. We assessed the relative accuracy of myocardial contrast echocardiography (MCE) and single-photon emission computed tomography (SPECT) to predict transmural extent of infarction after acute myocardial infarction. MCE, SPECT, and CMR were performed in 40 patients with acute myocardial infarction 7 to 10 days after thrombolysis. CMR was used to divide the transmural extent of infarction into 5 groups: 0%, 1% to 25%, 26% to 50%, 51% to 75%, and 76% to 100% in dysfunctional segments. MCE and SPECT were compared with assessment grades of transmural extent of infarction. There was a significant relation (p<0.0001) between decreasing contrast intensity as assessed qualitatively by MCE and increasing transmural extent of infarction on CMR as was the case for SPECT. The accuracy of MCE (77%) to predict>50% transmural extent of infarction (nonviable myocardium) was significantly (p=0.02) superior to that of SPECT (70%). Absence of uptake on MCE and SPECT virtually ruled out <or=50% of the transmural extent of infarction (negative predictive values 93% and 89%, respectively). MCE was significantly more sensitive than SPECT in differentiating between <or=25% and>25% transmural extent of infarction (84% vs 76%, p=0.03). MCE and SPECT correlate well with the transmural extent of infarction. However, MCE is significantly more accurate in predicting >50% of the transmural extent of infarction and more sensitive in identifying <or=25% of the transmural extent of infarction than SPECT.
|Title:||Comparison between myocardial contrast echocardiography and single-photon emission computed tomography for predicting transmurality of acute myocardial infarction.|
|Keywords:||Cohort Studies, Contrast Media, Echocardiography, Female, Gadolinium DTPA, Humans, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Myocardial Infarction, Myocardium, Sensitivity and Specificity, Severity of Illness Index, Thrombolytic Therapy, Tomography, Emission-Computed, Single-Photon|
|UCL classification:||UCL > School of Life and Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
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