In:
Echocardiography, Wiley, Vol. 33, No. 10 ( 2016-10), p. 1539-1545
Kurzfassung:
Infarct mass as assessed by myocardial‐delayed enhancement imaging on cardiac magnetic resonance ( CMR ) and myocardial blood flow as assessed by real time myocardial perfusion echocardiography ( RT ‐ MPE ) have been shown to predict adverse events following ST elevation myocardial infarction ( STEMI ). There has been no published comparison of quantitative assessment using these modalities as predictors of clinical outcomes to date. We compared RT ‐ MPE with CMR for prediction of cardiac events in reperfused STEMI patients. Materials and Methods Consecutive STEMI patients with early reperfusion were studied. RT ‐ MPE and CMR were performed. Perfusion score indices ( PSI RT ‐ MPE and PSI CMR ) were calculated [sum of segmental perfusion scores/number of segments]. CMR infarct mass (g) and RT ‐ MPE myocardial blood flow ( MBF dB /s) were quantified. Patients were followed for cardiac events (death, nonfatal MI , revascularization, angina, and heart failure). Results All 27 patients (age 62±14; follow‐up 3.5±2.6 years) had thrombolysis in myocardial infarction ( TIMI ) grade 3 flow of infarct vessel. Cardiac events occurred in 17 (63%). Cardiac event patients had higher PSI RT ‐ MPE , PSI CMR , infarct mass, and lower MBF . PSI RT ‐ MPE cutoff of 0.3 had an AUC of 0.856 (82% sensitivity, 70% specificity), while a PSI CMR cutoff of 0.2 had an AUC of 0.765 (76% sensitivity, 60% specificity). Infarct mass and MBF were independent predictors of cardiac events after adjusting for risk factors (hazard ratios: 20.9 [95% CI 1.8–256] P =.02 and 8.1 [95% CI 1.5–78] P =.01, respectively). Conclusions Quantitative RT ‐ MPE performed comparably to CMR for prediction of MACE in STEMI patients supporting a prognostic role for this noninvasive, bedside imaging method.
Materialart:
Online-Ressource
ISSN:
0742-2822
,
1540-8175
DOI:
10.1111/echo.2016.33.issue-10
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2016
ZDB Id:
2041033-5
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