Heart 1999;81:2-5 ( January )
Editorial
Myocardial contrast echocardiography in acute myocardial infarction: time to test for routine clinical use?
| The first 150 words of the full text of this article appear below. |
Coronary angiography has been used as the gold standard to determine whether reperfusion has been successful. TIMI (thrombolysis in myocardial infarction) grades have been developed for this purpose1 and have been shown to provide prognostic information. It has, however, been known for a quarter of a century that reflow in the infarct related artery does not necessarily imply tissue perfusion.2 It is also known, that regions within the myocardium that show poor tissue perfusion after reflow (no reflow or low reflow) have histological evidence of tissue necrosis.2 That myocardial contrast echocardiography (MCE) can define regions of no reflow was demonstrated nearly 15 years ago in a dog model.3
As is unfortunately often the case, the medical community either
ignored or was unaware of these experimental data. Not surprisingly, therefore, the first report of MCE documenting no reflow in patients who underwent reperfusion for acute myocardial infarction (AMI) published about five years
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