Up to 30% of patients with acute myocardial infarction (AMI) treated with reperfusion and with an apparently successful result have microvascular dysfunction. Multiple techniques are available for the diagnosis of this condition, but little information is available comparing their ability to predict ventricular recovery after AMI. The objective of our study was to compare the accuracy of myocardial contrast echocardiography (MCE) with that of myocardial blush grade (MBG) for this purpose, introducing quantitative MCE analysis.

METHODS

This was a prospective study of 68 consecutive patients undergoing primary angioplasty in our institution for a first ST segment elevation AMI < 24 hours after symptom onset. Patients with wall motion abnormalities in more than one vascular territory in the initial echocardiogram, previous coronary artery bypass surgery, or haemodynamic instability were excluded. Informed consent was obtained from all participants. Our institutional review board approved the study.

Standard echocardiography and real time MCE in apical views (contrast pulse sequencing; Acuson-Siemens) were performed 24–72 hours after reperfusion. MCE was performed with intravenous continuous infusion of the contrast agent BR-1 (Bracco), …