Evaluation of Transmural Myocardial Perfusion by Ultra-Harmonic Myocardial Contrast Echocardiography in Reperfused Acute Myocardial Infarction

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概要

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• Background The transmural distribution of myocardial perfusion is important for predicting the contractile reverse of an infarcted wall in reperfused acute myocardial infarction (AMI). Evaluating transmural myocardial perfusion by myocardial contrast echocardiography (MCE) could predict the long-term recovery of left ventricular (LV) function. Methods and Results The study group comprised 20 consecutive patients with a first-episode anterior AMI with total occlusion of the proximal left anterior descending artery, who underwent successful percutaneous coronary intervention within 24h of onset. MCE was performed on the 15th day after the onset, using ultrahar-monic gray-scale imaging with intermittent end-systolic triggering every 4 beats or every 6 beats. Regions of interest were placed over both the endocardial and epicardial region at the mid-septal level. Regional wall motion (RWM) of the infarcted anterior wall and global LV function were assessed by 2-dimensional echocardiography and left ventriculography in both the acute and chronic phase. The transmural distribution of myocar-dial perfusion by MCE demonstrated a significant relation with RWM score index (r=0.75, p=0.0004). Recovery of RWM and LV ejection fraction (LVEF) at 6 months after reperfusion was significantly greater in the group with good perfusion of the epicardium according to MCE than in the poor perfusion group [RWM (SD/cord); -1.23±0.91 vs-3.51±0.84, p=0.001, LVEF (%); 63.8±10.4 vs 47.0±3.4, p=0.04]. Conclusions Assessing the transmural distribution of myocardial perfusion by MCE can predict the long-term recovery of LV function after a reperfused AMI.

• 社団法人日本循環器学会の論文
• 2005-08-20

著者

• Ino Takashi

  First Department Of Integrated Medicine Omiya Medical Center Jichi Medical School

• Yasu Takanori

  First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University

• Kubo Norifumi

  First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University

• Kawakami Masanobu

  First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University

• Wada Hiroshi

  Saitama Medical Center Jichi Medical University

• Yasu Takanori

  First Department Of Integrated Medicine Saitama Medical Center Jichi Medical University

• Kubo Norifumi

  First Department Of Integrated Medicine Saitama Medical Center Jichi Medical University

• Tsuruya Yoshio

  Division Of Cardiology Saitama Social Insurance Hospital

• Saito Muneyasu

  First Department Of Integrated Medicine Saitama Medical Center Jichi Medical University

• Saito Muneyasu

  The Cardiovasucural Division Jichi Medical School Omiya Medical Center

• Yasu Takanori

  Department Of Clinical Pharmacology & Therapeutics University Of The Ryukyus Graduate School Of

• Kobayashi Yasuyuki

  First Department Of Integrated Medicine Omiya Medical Center Jichi Medical School

• Ishida Takeshi

  First Department of Integrated Medicine, Omiya Medical Center, Jichi Medical School

• Saito Muneyasu

  First Department Of Integrated Medicine Omiya Medical Center Jichi Medical University

• Kawakami M

  First Department Of Integrated Medicine Saitama Medical Center Jichi Medical University

• Hayakawa Yuhki

  Saitama Medical Center, Jichi Medical University

• Kotsuka Hiroyuki

  Saitama Medical Center, Jichi Medical University

• Wada Hiroshi

  First Department of Integrated Medicine, Omiya Medical Center, Jichi Medical School

• Kotsuka Hiroyuki

  First Department of Integrated Medicine, Omiya Medical Center, Jichi Medical School

• Hayakawa Yuhki

  First Department of Integrated Medicine, Omiya Medical Center, Jichi Medical School

• Tsukamoto Yoshiaki

  First Department of Integrated Medicine, Omiya Medical Center, Jichi Medical School

• Kobayashi Nobuhiko

  First Department of Integrated Medicine, Omiya Medical Center, Jichi Medical School

• Kawakami Masanobu

  First Department Of Integrated Medicine Saitama Medical Center Jichi Medical University

• Kobayashi Nobuhiko

  Department Of Medicine Jichi Medical School Omiya Medical Center

• Hayakawa Yuhki

  Saitama Medical Center Jichi Medical University

• Kubo Norifumi

  Cardiovascular Division Jichi Medical University Saitama Medical Center

• Saito Muneyasu

  Cardiovascular Division Department Of Integrated Medicine I

• Kotsuka Hiroyuki

  Saitama Medical Center Jichi Medical University

• Tada Yuuko

  Division Of Cardiology Saitama Medical Center Jichi Medical School

• Yasu Takanori

  Division Of Cardiovascular Medicine Department Of Integrated Medicine I Jichi Medical University Sai

• Turuya Yoshio

  Department Of Internal Medicine Saitama Medical Center Jichi Medical University

• Yasu Takanori

  First Department Of Integrated Medicine Omiya Medical Center Jichi Medical University

• Tada Yuko

  Cardiovascular Division Department Of Medicine Jichi Medical University Saitama Medical Center

• Kanda M

  Department Of Surgical Neurology Jichi Medical School Omiya Medical Center

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