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Prognostic Value of Real Time Myocardial Contrast Echocardiography after Percutaneous Coronary Intervention
Author(s) -
Yang Lixia,
Xia Chunmei,
Mu Yuming,
Guan Lina,
Wang Chunmei,
Tang Qi,
Verocai Flavia Gomes,
Fonseca Lea Mirian Barbosa da,
Shih Ming Chi
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13061
Subject(s) - conventional pci , medicine , timi , cardiology , percutaneous coronary intervention , coronary flow reserve , perfusion , blood flow , myocardial infarction
Real time myocardial contrast echocardiography (RTMCE) is a cost‐effective and simple method to quantify coronary flow reserve ( CFR ). We aimed to determine the value of RTMCE to predict cardiac events after percutaneous coronary intervention ( PCI ). We have studied myocardial blood volume (A), velocity ( β ), flow indexes ( MBF , A × β ), and vasodilator reserve (stress‐to‐rest ratios) in 36 patients with acute coronary syndrome ( ACS ) who underwent PCI . CFR ( MBF at stress/ MBF at rest) was calculated for each patient. Perfusion scores were used for visual interpretation by MCE and correlation with TIMI flow grade. In qualitative RTMCE assessment, post‐ PCI visual perfusion scores were higher than pre‐ PCI (Z = −7.26, P < 0.01). Among 271 arteries with TIMI flow grade 3 post‐ PCI , 72 (36%) did not reach visual perfusion score 1. The β ‐ and A × β ‐reserve of the abnormal segments supplied by obstructed arteries increased after PCI comparing to pre‐ PCI values (P < 0.01). Patients with adverse cardiac events had significantly lower β ‐ and lower A × β ‐reserve than patients without adverse cardiac events. In the former group, the CFR was ≥ 1.5 both pre‐ and post‐ PCI . CFR estimation by RTMCE can quantify myocardial perfusion in patients with ACS who underwent PCI . The parameters β ‐reserve and CFR combined might predict cardiac events on the follow‐up.