TY - JOUR
T1 - Real-time 3-dimensional echocardiography early after acute myocardial infarction
T2 - Incremental value of echo-contrast for assessment of left ventricular function
AU - Nucifora, Gaetano
AU - Marsan, Nina Ajmone
AU - Holman, Eduard R.
AU - Siebelink, Hans Marc J.
AU - van Werkhoven, Jacob M.
AU - Scholte, Arthur J.
AU - van der Wall, Ernst E.
AU - Schalij, Martin J.
AU - Bax, Jeroen J.
N1 - Funding Information:
Gaetano Nucifora is financially supported by the Research Fellowship of the European Association of Percutaneous Cardiovascular Interventions (Sophia Antipolis, France). Nina Ajmone Marsan is financially supported by the Research Fellowship of the European Society of Cardiology (Sophia Antipolis, France). Jacob M. van Werkhoven is financially supported by The Netherlands Society of Cardiology (Utrecht, the Netherlands). Martin J. Schalij has research grants from Biotronik (Berlin, Germany), Boston Scientific (Natick, MA), and Medtronic. Jeroen J. Bax has research grants from Biotronik, BMS Medical Imaging (North Billerica, MA), Boston Scientific, Edwards Lifesciences (Irvine, CA), GE Healthcare (Buckinghamshire, United Kingdom), Medtronic (Minneapolis, MN), and St. Jude Medical (St. Paul, MN).
PY - 2009/5
Y1 - 2009/5
N2 - Background: Accurate and reproducible assessment of left ventricular (LV) systolic function is important in patients with acute myocardial infarction (AMI). Real-time 3-dimensional echocardiography (RT3DE) is an accurate technique, but it relies heavily on good image quality. The aim of the present study was to evaluate the incremental value of contrast-enhanced RT3DE. Methods: A total of 140 consecutive patients (58 ± 11 years, 78% men) with ST-elevation AMI clinically underwent nonenhanced and contrast-enhanced RT3DE within 24 hours from AMI to evaluate global and regional LV systolic function. Endocardial border definition was graded for each of the 16 LV segments as follows: 0 = border invisible, 1 = border visualized only partially, and 2 = complete visualization of the border. Three image-quality groups (good, fair, and uninterpretable) were identified. Left ventricular volumes and ejection fraction were measured off-line. Wall motion was graded for each visible segment as follows: 1 = normal, 2 = hypokinetic, 3 = akinetic, and 4 = dyskinetic. Results: During contrast-enhanced RT3DE, as compared with nonenhanced RT3DE, the number of segments with complete visualization of the endocardial border increased from 66% to 84% (P < .001); and the number of patients with a good-quality echocardiogram increased from 59% to 94% (P < .001). Intra- and interobserver agreement for assessment of global and regional LV systolic function improved during contrast-enhanced RT3DE, as compared with nonenhanced RT3DE. Conclusions: Assessment of LV systolic function in AMI patients with RT3DE is frequently hampered by suboptimal echocardiographic quality. Contrast-enhanced RT3DE is of incremental value, improving the endocardial border visualization and the reproducibility of LV function assessment.
AB - Background: Accurate and reproducible assessment of left ventricular (LV) systolic function is important in patients with acute myocardial infarction (AMI). Real-time 3-dimensional echocardiography (RT3DE) is an accurate technique, but it relies heavily on good image quality. The aim of the present study was to evaluate the incremental value of contrast-enhanced RT3DE. Methods: A total of 140 consecutive patients (58 ± 11 years, 78% men) with ST-elevation AMI clinically underwent nonenhanced and contrast-enhanced RT3DE within 24 hours from AMI to evaluate global and regional LV systolic function. Endocardial border definition was graded for each of the 16 LV segments as follows: 0 = border invisible, 1 = border visualized only partially, and 2 = complete visualization of the border. Three image-quality groups (good, fair, and uninterpretable) were identified. Left ventricular volumes and ejection fraction were measured off-line. Wall motion was graded for each visible segment as follows: 1 = normal, 2 = hypokinetic, 3 = akinetic, and 4 = dyskinetic. Results: During contrast-enhanced RT3DE, as compared with nonenhanced RT3DE, the number of segments with complete visualization of the endocardial border increased from 66% to 84% (P < .001); and the number of patients with a good-quality echocardiogram increased from 59% to 94% (P < .001). Intra- and interobserver agreement for assessment of global and regional LV systolic function improved during contrast-enhanced RT3DE, as compared with nonenhanced RT3DE. Conclusions: Assessment of LV systolic function in AMI patients with RT3DE is frequently hampered by suboptimal echocardiographic quality. Contrast-enhanced RT3DE is of incremental value, improving the endocardial border visualization and the reproducibility of LV function assessment.
UR - http://www.scopus.com/inward/record.url?scp=64449083126&partnerID=8YFLogxK
U2 - 10.1016/j.ahj.2009.02.002
DO - 10.1016/j.ahj.2009.02.002
M3 - Article
C2 - 19376315
AN - SCOPUS:64449083126
SN - 0002-8703
VL - 157
SP - 882.e1-882.e8
JO - American Heart Journal
JF - American Heart Journal
IS - 5
ER -