http://www.cnr.it/ontology/cnr/individuo/prodotto/ID23628
Serial evaluation of perfusion defects in patients with a fist acute myocardial infarction referred for primary PTCA using intravenous myocardial contrast echocardiography (Articolo in rivista)
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- Serial evaluation of perfusion defects in patients with a fist acute myocardial infarction referred for primary PTCA using intravenous myocardial contrast echocardiography (Articolo in rivista) (literal)
- Anno
- 2001-01-01T00:00:00+01:00 (literal)
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Kamp O 1) , Lepper W 2) , Vanoverschelde JL 3) , Aeschbacher BC 4) , Rovai D 5) , Assayag P 6) , Voci P 7), Kloster Y 8) , 5) Distante A, 1) Visser CA. (2001)
Serial evaluation of perfusion defects in patients with a fist acute myocardial infarction referred for primary PTCA using intravenous myocardial contrast echocardiography
in European heart journal
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- Kamp O 1) , Lepper W 2) , Vanoverschelde JL 3) , Aeschbacher BC 4) , Rovai D 5) , Assayag P 6) , Voci P 7), Kloster Y 8) , 5) Distante A, 1) Visser CA. (literal)
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- Il lavoro è stato pubblicato sullEuropean Heart Journal, che è la principale rivista europea di Cardiologia, che nel 2001 aveva un impact factor di 5.153, un immediacy index di 1.540 e una cited half life di 5.3. (literal)
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- Questo è un lavoro policentrico sulla sicurezza ed efficacia del mezzo di contrasto ecocardiografico Sonazoid nei pazienti con infarto miocardico acuto. E il primo lavoro effettuato con questo agente in un modello clinico complesso come linfarto miocardico acuto e che assume come gold standard la coronarografia. Questo studio clinico è stato disegnato presso lIstituto di Fisiologia Clinica del CNR in quanto il primo studio effettuato con lo stesso agente di contrasto in un modello sperimentale di infarto miocardico acuto era stato realizzato presso questo Istituto. Due degli autori appartengono infatti a questo Istituto e lanalisi dei dati è stata effettuata a Pisa. Lo studio mostra la possibilità di valutare la perfusione miocardica con contrasto eco nelluomo, la sicurezza di questo approccio e la possibilità di seguire nel tempo le modificazioni della perfusione. (literal)
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- ISI Web of Science (WOS) (literal)
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- 1) O. Kamp and C. A. Visser: University Hospital Vrije Universiteit, Amsterdam, The Netherlands
2) W. Lepper, Medical Clinic I, Aachen, Germany
3) J.-L. Vanoverschelde, Universite´ Catholique de Louvain, Brussels, Belgium
4) B. C. Aeschbacher, Heart Center, Bern, Switzerland
5) D. Rovai and A. Distante Institute of Clinical Physiology, Pisa, Italy
6) P. Assayag, Hôpital Bichat, Paris, France
7) P. Voci, Core Laboratory, Pisa, Italy
8) Y. Kloster Nycomed Imaging, Oslo, Norway
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- Titolo
- Serial evaluation of perfusion defects in patients with a fist acute myocardial infarction referred for primary PTCA using intravenous myocardial contrast echocardiography (literal)
- Abstract
- Aims To investigate whether myocardial contrast echocardiography using Sonazoid could be used for the serial evaluation of the presence and extent of myocardial perfusion defects in patients with a first acute myocardial infarction treated with primary PTCA, and specifically, (1) to evaluate safety and efficacy of myocardial contrast echocardiography to detect TIMI flow grade 02, (2) to evaluate the success of reperfusion and (3) to predict left ventricular recovery after 4 weeks follow-up.
Methods and Results Fifty-nine patients underwent serial myocardial contrast echocardiography, immediately before primary PTCA (MCE1), 1 h (MCE2) and 1224 h after PTCA (MCE3). A perfusion defect was observed in 21 of 24 patients (88%) with anterior acute myocardial infarction. All but one had TIMI flow grade 02 prior to PTCA. Nine of 31 patients (29%) with inferior acute myocardial infarction showed a perfusion defect and all had TIMI flow grade 02 prior to PTCA. Restoration of TIMI flow grade 3 was achieved in 73% of the patients by primary PTCA. A reduction in size of the initial perfusion defect of at least one segment (16 segment model) or no defect vs persistent defect in patients with anterior acute myocardial infarction was associated with improved global left ventricular function at 4 weeks; mean global wall motion score index 1·29_0·21 vs 1·66_0·31 (P=0·009). Multiple regression analysis in patients with an anterior acute myocardial infarction revealed that the extent of the perfusion defect at MCE3 was a significant (P=0·0005) independent predictor for left ventricular recovery at 4 weeks follow-up. The only other independent predictor was TIMI flow grade 3 post PTCA (P=0·007).
Conclusion Intravenous myocardial contrast echocardiography immediately prior to primary PTCA seems safe and is capable of detecting the presence of a perfusion defect and its subsequent dynamic changes, particularly in patients with a first anterior acute myocardial infarction. A significant reduction in size of the initial perfusion defect using serial myocardial contrast echocardiography predicts functional recovery after 4 weeks and these findings underscore the potential diagnostic value of intravenous myocardial contrast echocardiography.
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