1996 Volume 27 Issue 1 Pages 41-50
The value of myocardial contrast echocardiography (MCE) for predicting left ventricular wall motion after percutaneous transluminal coronary angioplasty (PTCA) was investigated. The subjects were 21 patients undergoing PTCA of the left anterior descending coronary artery (LAD) at 1-3 months after acute anteroseptal myocardial infarction. MCE was performed immediately after PTCA, and the ratio of the peak intensity (Pl) of myocardial staining for each of the 3 segments supplied by the LAD to that for the posterior wall (Pl ratio) was calculated using computer image analysis. Results were compared with the conventional contrast score determined visually. A significant correlation was observed between the Pl ratio and the wall motion score at 3 months after PTCA (r=-0.67, p<0.01). The Pl ratio was 0.90±0.21 for normokinetic segments, 0.73±0.13 for hypokinetic segments, 0.75±0.16 for severely hypokinetic segments, and 0.47±0.19 for akinetic segments. Thus, the Pl ratio decreased along with the progressive impairment of wall motion. In addition, post-PTCA wall motion inproved as the Pl ratio increased. When the Pl ratio was ≥0.6, improvement of wall motion at 3 months after PTCA could be predicted with a sensitivity of 100.0% and a specificity of 75.0%, even for akinetic segments. These values were higher than those for visual evaluation. The results suggested that quantitation of myocardial staining using the Pl ratio determined by MCE may be useful for predicting long-term left ventricular wall motion recovery after PTCA.
