Identification of viable myocardium with contrast echocardiography in patients with poor left ventricular systolic function caused by recent or remote myocardial infarction

Gustavo Camarano, Michael Ragosta, Lawrence W. Gimple, Eric R. Powers, Sanjiv Kaul

    Research output: Contribution to journalArticle

    49 Scopus citations

    Abstract

    We hypothesized that viable myocardium can be identified in patients with poor left ventricular (LV) systolic function caused by recent or prior infarction using myocardial contrast echocardiography. Accordingly, 39 patients with reduced LV ejection fraction (range 0.10 to 0.40) and recent (n = 30) or remote (n = 9) myocardial infarction were studied. Echocardiography was performed at baseline and at 1 month to assess regional function (1 = normal, 5 = dyskinesia) in 12 segments/patient; the segments were also scored for contrast effect (1 = homogenous, 0.5 = partial, 0 = none) during contrast echocardiography performed in the cardiac catheterization laboratory. Four patients had unsuccessful angioplasty of occluded arteries and were treated medically, 9 were treated medically because of noncritical coronary stenoses (<80%), and 26 underwent revascularization (16 angioplasty and 10 bypass operation). Twelve segments could not be visualized (2 each in 6 patients), and 30 segments continued to be subserved by totally occluded arteries because of unsuccessful angioplasty in 4 patients. Of the remaining 426 segments, 186 (44%) demonstrated baseline wall motion scores of ≥3. The best correlate of 1-month wall motion score in these segments was the contrast score (ρ = -0.62), with better 1-month function noted in segments with more contrast. The overall perfusion status of LV myocardium also correlated (ρ = -0.59) with global LV systolic function at 1 month. We conclude that myocardial contrast echocardiography can be used during cardiac catheterization to define myocardial segments that are viable in patients with poor LV systolic function caused by recent or remote myocardial infarction.

    Original languageEnglish (US)
    Pages (from-to)215-219
    Number of pages5
    JournalThe American Journal of Cardiology
    Volume75
    Issue number4
    DOIs
    StatePublished - Feb 1 1995

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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