The Extent of Microvascular Damage During Myocardial Contrast Echocardiography Is Superior to Other Known Indexes of Post-Infarct Reperfusion in Predicting Left Ventricular RemodelingResults of the Multicenter AMICI Study
Leonarda Galiuto, MD, PhD, FACC*,*,
Barbara Garramone, MD*,
Antonio Scarà, MD*,
Antonio G. Rebuzzi, MD*,
Filippo Crea, MD, FACC*,
Giuseppe La Torre, MD, Msc ,
Stefania Funaro, MD ,
Mariapina Madonna, MD ,
Francesco Fedele, MD,
Luciano Agati, MD on behalf of the AMICI Investigators
* Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
Epidemiology and Biostatistics Unit, Institute of Hygiene, Catholic University, Rome, Italy
Division of Cardiology, Catholic University of the Sacred Heart, Campobasso, Italy
Department of Cardiology, La Sapienza University, Rome, Italy.
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Figure 1 Example of Myocardial Contrast Echocardiography
(A) Myocardial contrast echocardiography in 4-chamber view on day 1 shows a large contrast defect on the lateral wall (between arrows) with normal end-diastolic volume. (B) Two-dimensional echocardiogram of the same patient at 6-month follow-up shows an enlarged left ventricle.
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Figure 2 Prediction of Left Ventricular Remodeling
Sensitivity and specificity of different parameters studied in the prediction of left ventricular remodeling. CD = contrast defect; CSI = contrast score index; EF = ejection fraction; MBG = myocardial blush grade; TIMI = Thrombolysis In Myocardial Infarction; WMSI = wall motion score index.
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Figure 3 Correlations Between Perfusion and Function
(Left) Correlation between contrast defect (CD) length on day 1 after reperfusion and WMSI at 6-month follow-up (WMSI – F/U) (top panel) and ejection fraction (EF% – F/U) (bottom panel). (Right) Correlation between ST-segment recovery after reperfusion and WMSI at 6-month follow-up (WMSI – F/U) (top panel) and ejection fraction (EF% – F/U) (bottom panel) as parameters of left ventricular function. Abbreviations as in Figure 2.
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