Assessment of infarcted myocardium with real time myocardial contrast echocardiography: comparison with technetium-99m sestamibi single photon emission computed tomography
- Correspondence to:
Priv-Doz Dr med C Firschke
Deutsches Herzzentrum München, Lazarettstraße 36, D-80636 Munich, Germany;
- Accepted 17 February 2005
- Published Online First 17 March 2005
Background: Little is known about the relation between the extent of microvascular damage and infarct size in patients after successful mechanical reperfusion of acute myocardial infarction.
Objective:: To compare the spatial extent of reduced myocardial signal between real time myocardial contrast echocardiography (MCE) and single photon emission computed tomography (SPECT) after successful mechanical reperfusion of acute myocardial infarction and to test the hypothesis that MCE can be used for clinical infarct size assessment.
Methods: 10 days after successful mechanical reperfusion of acute myocardial infarction, 117 patients underwent MCE (power pulse inversion technique, slow contrast bolus injection) and SPECT (technetium-99m sestamibi). Location and number of segments with normal myocardial signal intensity and with mild and severe reduction were registered and the concordance between the techniques was calculated.
Results: Segmental concordance between MCE and SPECT was 83% (κ = 0.64). On average, the difference in the number of segments with reduced myocardial signal intensity between MCE and SPECT did not exceed one segment (p < 0.001). Sensitivity and specificity of MCE for the detection of an abnormal segment on SPECT were 87% and 91%, respectively. Intraobserver and interobserver agreement were 94% (κ = 0.84) and 92% (κ = 0.83), respectively.
Conclusions: Real time MCE is a promising technique for infarct size assessment after successful mechanical reperfusion of acute myocardial infarction.
- MCE, myocardial contrast echocardiography
- SPECT, single photon emission computed tomography
- STOPAMI, stent versus thrombolysis for occluded coronary arteries in patients with acute myocardial infarction
Published Online First 17 March 2005
Dr Tousek was supported by a grant from the German Cardiac Society, Düsseldorf, Germany. Dr Orban was supported by a grant from the Czech Cardiac Society, Brno, Czech Republic.