Clinical validity of longitudinal pre-ejectional myocardial velocity for identifying the transmural extent of viable myocardium: early after reperfusion of an infarct-related coronary artery.
Circ J
; 71(12): 1904-11, 2007 Dec.
Article
em En
| MEDLINE
| ID: mdl-18037744
ABSTRACT
BACKGROUND:
Positive longitudinal pre-ejectional velocity (+PEVL) was recently reported to be a reliable index of myocardial recovery early after successful revascularization in myocardial infarction (MI); that is, it recognizes the transmural extent of viable myocardium. The applicability of PEVL in the real-world clinical setting for identifying the transmural extent of viable myocardium in reperfused recent MI was assessed. METHODS ANDRESULTS:
Using tissue Doppler imaging, the resting basal and mid myocardial PEVLs were determined within 3 days after revascularization in 41 consecutive patients with recent MI. Infarct thickness was semi-quantified using delayed gadolinium-enhanced magnetic resonance imaging (MRI) at baseline and at 6-month follow up to differentiate transmural from nontransmural MI. The proportion of segments showing the presence of +PEVL was not significantly changed as infarct thickness increased (p=0.2), with 66.2% having +PEVL even in segments involving >75% transmural infarction. Moreover, +PEVL was found in a large fraction of segments with akinesia (70.4%). Specificity and negative predictive value of +PEVL for assessing infarct nontransmurality were disappointingly low (32.0% and 26.9%, respectively). All of these results were not altered when the 6-month follow-up MRI was done.CONCLUSIONS:
+PEVL cannot be regarded as a reliable marker for predicting the transmural extent of viable myocardium in recent MI.
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Base de dados:
MEDLINE
Assunto principal:
Volume Sistólico
/
Imageamento por Ressonância Magnética
/
Ecocardiografia Doppler
/
Reperfusão Miocárdica
/
Vasos Coronários
/
Infarto do Miocárdio
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2007
Tipo de documento:
Article