以心臟超音波組織特性預測急性心肌梗塞後冠狀動脈阻塞或再灌流之研究
Other Title
The Study of Ultrasonic Tissue Characterization for Evaluating Coronary
Stenosis or Reperfusion after Acute Myocardial Infarction.
Stenosis or Reperfusion after Acute Myocardial Infarction.
Date Issued
1999
Date
1999
Author(s)
高憲立
DOI
882314B002331
Abstract
Background The identification of viable myocardium and residual ischemia in
patients with acute myocardial infarction (AMI) has important prognostic implications.
The ultrasonic tissue characterization (UTC) with integrated backscatter has been
shown to be a sensitive marker of myocardial ischemia and infarction. After
reperfusion of occluded coronary artery, the cardiac cyclic-dependent variation of
integrated backscatter restores its amplitude modulation before the recovery of
myocardial contractility. It implies that the promising method can be used to identify
stunning myocardium.
Methods and Results UTC and dobutamine-atropine stress echocardiography (DSE)
were performed 8.3±3 days after AMI in 30 patients. The DSE was considered as a
reference to identify viable myocardium and residual ischemia. After coronary
intervention, both modalities were performed to evaluate the influences of residual
stenosis. The parameter obtained from UTC, phase-weighted variation, could
differentiate the myocardium with residual coronary stenosis or nonviable from the
viable myocardium without residual coronary stenosis (p<0.001). The latter has the
similar value to that of normal control group (p=0.453). Using the cutoff value of 5.8,
the sensitivity, specificity, and accuracy for detecting viable myocardium without
residual infarct-related artery stenosis were 75%, 100%, and 90.2%, respectively. The
phase-weighted variation of viable infarction zone restored after the coronary stenosis
was relieved. Contrarily, the nonviable myocardium had small phase-weighted
variation irrelevant to the patency of infarct-related artery.
Conclusions The UTC was a very useful method to identify the viable myocardium
of which infarct-related artery was free from residual stenosis. It can be used as a
predischarge screening tool for risk stratification and is helpful in constructing the
intervention strategy.
Subjects
myocardial infarction
echocardiography
ischemia
stunning
myocardial
Publisher
臺北市：國立臺灣大學醫學院內科
Type
report
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