Advertisement

Myocardial Contrast Echocardiography in Acute Myocardial Infarction

  • Esther Pérez David
  • Teresa López Fernández
  • José Luis Zamorano
  • Miguel Angel García Fernández

Abstract

For the last 20 years, pharmacological or mechanical reperfusion therapy, focused on restoration of patency of the infarct-related artery, has been the cornerstone of the initial treatment of acute myocardial infarction (AMI). A large number of clinical trials have shown that complete recanalization of the occluded epicardial coronary artery significantly improves short and long-term prognosis [1–3]. It has also been shown that in order to improve prognosis it is essential to minimize the time from onset of symptoms to recanalization of infarct-related artery [4].

Keywords

Myocardial Perfusion Acute Myocardial Infarction Infarct Size Acute Myocardial Infarc Myocardial Blood Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    FTT. Indications for fibrinolytic therapy in suspected acute myocardial infarction. Collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. Lancet 1994; 343: 311–322Google Scholar
  2. 2.
    Zijlstra F, Hoorntje JC, de Boer MJ, Reiffers S, Miedema K, Ottervanger JP, et al. Long-term benefit of primary angioplasty as compared with thrombolytic therapy for acute myocardial infarction. N Engl J Med 1999; 341 (19): 1413–9PubMedCrossRefGoogle Scholar
  3. 3.
    Schomig A, Kastrati A, Dirschinger J, Mehilli J, Schricke U, Pache J, et al. Coronary stenting plus platelet glycoprotein IIb/IIIa blockade compared with tissue plasminogen activator in acute myocardial infarction. Stent versus Thrombolysis for Occluded Coronary Arteries in Patients with Acute Myocardial Infarction Study Investigators. N Engl J Med 2000; 343 (6): 385–91PubMedCrossRefGoogle Scholar
  4. 4.
    GISSI. Gruppo Italiano per lo studio della strep-tochinasi nell ’Infarto miocardico (GISSI). Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1986 (1): 397–401Google Scholar
  5. 5.
    Ito H, Maruyama A, Iwakura K, Takiuchi S, Masuyama T, Hori M, et al. Clinical implications of the ‘no reflow’ phenomenon. A predictor of complications and left ventricular remodeling in reperfused anterior wall myocardial infarction. Circulation 1996; 93 (2): 223–8PubMedCrossRefGoogle Scholar
  6. 6.
    Topol EJ, Yadav JS. Recognition of the importance of embolization in atherosclerotic vascular disease. Circulation 2000; 101 (5): 570–80PubMedCrossRefGoogle Scholar
  7. 7.
    Reimer KA, Jennings RB. The “wavefront phenomenon” of myocardial ischemic cell death. II. Transmural progression of necrosis within the framework of ischemic bed size (myocardium at risk) and collateral flow. Lab Invest 1979; 40 (6): 633–44PubMedGoogle Scholar
  8. 8.
    Kloner RA, Ganote CE, Jennings RB. The “no-reflow” phenomenon after temporary coronary occlusion in the dog. J Clin Invest 1974; 54 (6): 1496–508PubMedCrossRefGoogle Scholar
  9. 9.
    Kemper AJ, O ’Boyle JE, Cohen CA, Taylor A, Parisi AF. Hydrogen peroxide contrast echocardiography: quantification in vivo of myocardial risk area during coronary occlusion and of the necrotic area remaining after myocardial reperfusion. Circulation 1984; 70 (2): 309–17PubMedCrossRefGoogle Scholar
  10. 10.
    Lindner JR, Ismail S, Spotnitz WD, Skyba DM, Jayaweera AR, Kaul S. Albumin microbubble persistence during myocardial contrast echocardiography is associated with microvascular endothelial glycocalyx damage. Circulation 1998; 98 (20): 2187–94PubMedCrossRefGoogle Scholar
  11. 11.
    Kaul S, Glasheen W, Ruddy TD, Pandian NG, Weyman AE, Okada RD. The importance of defining left ventricular area at risk in vivo during acute myocardial infarction: an experimental evaluation with myocardial contrast two-dimensional echocardiography. Circulation 1987; 75 (6): 1249–60PubMedCrossRefGoogle Scholar
  12. 12.
    Sabia PJ, Powers ER, Jayaweera AR, Ragosta M, Kaul S. Functional significance of collateral blood flow in patients with recent acute myocardial infarction. A study using myocardial contrast echocardiography. Circulation 1992; 85 (6): 2080–9PubMedCrossRefGoogle Scholar
  13. 13.
    Kaul S, Pandian NG, Guerrero JL, Gillam LD, Okada RD, Weyman AE. Effects of selectively altering collateral driving pressure on regional perfusion and function in occluded coronary bed in the dog. Circ Res 1987; 61 (1): 77–85PubMedCrossRefGoogle Scholar
  14. 14.
    Kemper AJ, Force T, Perkins L, Gilfoil M, Parisi AF. In vivo prediction of the transmural extent of experimental acute myocardial infarction using contrast echocardiography. J Am Coll Cardiol 1986; 8 (1): 143–9PubMedCrossRefGoogle Scholar
  15. 15.
    Coggins MP, Sklenar J,Le DE, Wei K, Lindner JR, Kaul S. Noninvasive prediction of ultimate infarct size at the time of acute coronary occlusion based on the extent and magnitude of collateral-derived myocardial blood flow. Circulation 2001; 104 (20): 2471–7PubMedCrossRefGoogle Scholar
  16. 16.
    Feiring AJ, Johnson MR, Kioschos JM, Kirchner PT, Marcus ML, White CW. The importance of the determination of the myocardial area at risk in the evaluation of the outcome of acute myocardial infarction in patients. Circulation 1987; 75 (5): 980–7PubMedCrossRefGoogle Scholar
  17. 17.
    Touchstone DA, Nygaard TW, Kaul S. Correlation between left ventricular risk area and clinical, electrocardiographic, hemodynamic, and angiographic variables during acute myocardial infarction. J Am Soc Echocardiogr 1990; 3 (2): 106–17PubMedGoogle Scholar
  18. 18.
    Kaul S. Assessment of myocardial perfusion with contrast echocardiography. In: Principles and practice of echocardiography, A Weyman. Ed Lea fcFebiger 1994: 687–719Google Scholar
  19. 19.
    Kamp O, Lepper W, Vanoverschelde JL, Aeschbacher BC, Rovai D, Assayag P, et al. Serial evaluation of perfusion defects in patients with a first acute myocardial infarction referred for primary PTCA using intravenous myocardial contrast echocardiography. Eur Heart J 2001; 22 (16): 1485–95PubMedCrossRefGoogle Scholar
  20. 20.
    Vernon SM, Camarano G, Kaul S, Sarembock IJ, Gimple LW, Powers ER, et al. Myocardial contrast echocardiography demonstrates that collateral flow can preserve myocardial function beyond a chronically occluded coronary artery. Am J Cardiol 1996; 78 (8): 958–60PubMedCrossRefGoogle Scholar
  21. 21.
    Sabia PJ, Powers ER, Ragosta M, Sarembock IJ, Burwell LR, Kaul S. An association between collateral blood flow and myocardial viability in patients with recent myocardial infarction. N Engl J Med 1992; 327 (26): 1825–31PubMedCrossRefGoogle Scholar
  22. 22.
    Puma JA, Sketch MH, Jr., Thompson TD, Simes RJ, Morris DC, White HD, et al. Support for the openartery hypothesis in survivors of acute myocardial infarction: analysis of 11,228 patients treated with thrombolytic therapy. Am J Cardiol 1999; 83 (4): 482–7PubMedCrossRefGoogle Scholar
  23. 23.
    Ambrosio G, Weisman HF, Mannisi JA, Becker LC. Progressive impairment of regional myocardial perfusion after initial restoration of postischemic blood flow. Circulation 1989; 80 (6): 1846–61PubMedCrossRefGoogle Scholar
  24. 24.
    Kloner RA. Does reperfusion injury exist in humans? J Am Coll Cardiol 1993; 21 (2): 537–45PubMedCrossRefGoogle Scholar
  25. 25.
    Rezkalla SH, Kloner RA. No-reflow phenomenon. Circulation 2002; 105 (5): 656–62PubMedCrossRefGoogle Scholar
  26. 26.
    Kondo M, Nakano A, Saito D, Shimono Y. Assessment of “microvascular no-reflow phenomenon” using technetium-99m macroaggregated albumin scintigraphy in patients with acute myocardial infarction. J Am Coll Cardiol 1998; 32 (4): 898–903PubMedCrossRefGoogle Scholar
  27. 27.
    Bremerich J, Wendland MF, Arheden H, Wyttenbach R, Gao DW, Huberty JP, et al. Microvascular injury in reperfused infarcted myocardium: noninvasive assessment with contrast-enhanced echoplanar magnetic resonance imaging. J Am Coll Cardiol 1998; 32 (3): 787–93PubMedCrossRefGoogle Scholar
  28. 28.
    Jeremy RW, Links JM, Becker LC. Progressive failure of coronary flow during reperfusion of myocardial infarction: documentation of the no reflow phenomenon with positron emission tomography. J Am Coll Cardiol 1990; 16 (3): 695–704PubMedCrossRefGoogle Scholar
  29. 29.
    Iliceto S, Marangelli V, Marchese A, Amico A, Galiuto L, Rizzon P. Myocardial contrast echocardiography in acute myocardial infarction. Pathophysiological background and clinical applications. Eur Heart J 1996; 17 (3): 344–53PubMedCrossRefGoogle Scholar
  30. 30.
    Lindner JR, Firschke C, Wei K, Goodman NC, Skyba DM, Kaul S. Myocardial perfusion characteristics and hemodynamic profile of MRX-115, a venous echocardiographic contrast agent, during acute myocardial infarction. J Am Soc Echocardiogr 1998; 11(1): 36–46PubMedCrossRefGoogle Scholar
  31. 31.
    Villanueva FS, Camarano G, Ismail S, Goodman NC, Sklenar J, Kaul S. Coronary reserve abnormalities in the infarcted myocardium. Assessment of myocardial viability immediately versus late after reflow by contrast echocardiography. Circulation 1996; 94 (4): 748–54PubMedCrossRefGoogle Scholar
  32. 32.
    Johnson WB, Malone SA, Pantely GA, Anselone CG, Bristow JD. No reflow and extent of infarction during maximal vasodilation in the porcine heart. Circulation 1988; 78 (2): 462–72PubMedCrossRefGoogle Scholar
  33. 33.
    Vanhaecke J, Flameng W, Borgers M, Jang IK, Van de Werf F, De Geest H. Evidence for decreased coronary flow reserve in viable postischemic myocardium. Circ Res 1990; 67 (5): 1201–10PubMedCrossRefGoogle Scholar
  34. 34.
    Porter TR, Xie F, Kricsfeld A, Kilzer K. Noninvasive identification of acute myocardial ischemia and reperfusion with contrast ultrasound using intravenous perfluoropropane-exposed sonicated dextrose albumin. J Am Coll Cardiol 1995; 26 (1): 33–40PubMedCrossRefGoogle Scholar
  35. 35.
    Meza M, Greener Y, Hunt R, Perry B, Revall S, Barbee W, et al. Myocardial contrast echocardiography: reliable, safe, and efficacious myocardial perfusion assessment after intravenous injections of a new echocardiographic contrast agent. Am Heart J 1996; 132 (4): 871–81PubMedCrossRefGoogle Scholar
  36. 36.
    Cobb FR, Bache RJ, Rivas F, Greenfield JC, Jr. Local effects of acute cellular injury on regional myocardial blood flow. J Clin Invest 1976; 57 (5): 1359–68PubMedCrossRefGoogle Scholar
  37. 37.
    Villanueva FS, Glasheen WP, Sklenar J, Kaul S. Characterization of spatial patterns of flow within the reperfused myocardium by myocardial contrast echocardiography. Implications in determining extent of myocardial salvage. Circulation 1993; 88 (6): 2596–606PubMedCrossRefGoogle Scholar
  38. 38.
    Sklenar J, Camarano G, Goodman NC, Ismail S, Jayaweera AR, Kaul S. Contractile versus microvascular reserve for the determination of the extent of myocardial salvage after reperfusion. The effect of residual coronary stenosis. Circulation 1996; 94 (6): 1430–40PubMedCrossRefGoogle Scholar
  39. 39.
    Bolli R, Triana JF, Jeroudi MO. Prolonged impairment of coronary vasodilation after reversible ischemia. Evidence for microvascular “stunning”. Circ Res 1990; 67 (2): 332–43PubMedCrossRefGoogle Scholar
  40. 40.
    Kaul S. Myocardial contrast echocardiography. Curr Probl Cardiol 1997; 22(11): 549–635PubMedCrossRefGoogle Scholar
  41. 41.
    Ito H, Tomooka T, Sakai N, Yu H, Higashino Y, Fujii K, et al. Lack of myocardial perfusion immediately after successful thrombolysis. A predictor of poor recovery of left ventricular function in anterior myocardial infarction. Circulation 1992; 85 (5): 1699–705PubMedCrossRefGoogle Scholar
  42. 42.
    Ito H, Okamura A, Iwakura K, Masuyama T, Hori M, Takiuchi S, et al. Myocardial perfusion patterns related to thrombolysis in myocardial infarction perfusion grades after coronary angioplasty in patients with acute anterior wall myocardial infarction. Circulation 1996; 93 (11): 1993–9PubMedCrossRefGoogle Scholar
  43. 43.
    Matetzky S, Novikov M, Gruberg L, Freimark D, Fein-berg M, Elian D, et al. The significance of persistent ST elevation versus early resolution of ST segment elevation after primary PTCA. J Am Coll Cardiol 1999; 34 (7): 1932–8PubMedCrossRefGoogle Scholar
  44. 44.
    Claeys MJ, Bosmans J, Veenstra L, Jorens P, De Raedt H, Vrints CJ. Determinants and prognostic implications of persistent ST-segment elevation after primary angioplasty for acute myocardial infarction: importance of microvascular reperfusion injury on clinical outcome. Circulation 1999; 99 (15): 1972–7PubMedCrossRefGoogle Scholar
  45. 45.
    Santoro GM, Valenti R, Buonamici P, Bolognese L, Cerisano G, Moschi G, et al. Relation between ST-segment changes and myocardial perfusion evaluated by myocardial contrast echocardiography in patients with acute myocardial infarction treated with direct angioplasty. Am J Cardiol 1998; 82 (8): 932–7PubMedCrossRefGoogle Scholar
  46. 46.
    Sakuma T, Leong-Poi H, Fisher NG, Goodman NC, Kaul S. Further insights into the no-reflow phenomenon after primary angioplasty in acute myocardial infarction: The role of microthromboemboli. J Am Soc Echocardiogr 2003; 16 (1): 15–21PubMedCrossRefGoogle Scholar
  47. 47.
    Rocchi G, Kasprzak JD, Galema TW, de Jong N, Ten Cate FJ. Usefulness of power Doppler contrast echocardiography to identify reperfusion after acute myocardial infarction. Am J Cardiol 2001; 87 (3): 278–82PubMedCrossRefGoogle Scholar
  48. 48.
    Swinburn JM, Lahiri A, Senior R. Intravenous myocardial contrast echocardiography predicts recovery of dysynergic myocardium early after acute myocardial infarction. J Am Coll Cardiol 2001; 38 (1): 19–25PubMedCrossRefGoogle Scholar
  49. 49.
    Porter TR, Li S, Oster R, Deligonul U. The clinical implications of no reflow demonstrated with intravenous perfluorocarbon containing microbubbles following restoration of Thrombolysis In Myocardial Infarction (TIMI) 3 flow in patients with acute myocardial infarction. Am J Cardiol 1998; 82 (10): 1173–7PubMedCrossRefGoogle Scholar
  50. 50.
    Ito H, Iwakura K, Oh H, Masuyama T, Hori M, Higashino Y, et al. Temporal changes in myocardial perfusion patterns in patients with reperfused anterior wall myocardial infarction. Their relation to myocardial viability. Circulation 1995; 91 (3): 656–62PubMedCrossRefGoogle Scholar
  51. 51.
    Asanuma T, Tanabe K, Ochiai K, Yoshitomi H, Nakamura K, Murakami Y, et al. Relationship between progressive microvascular damage and intramyocardial hemorrhage in patients with reperfused anterior myocardial infarction: myocardial contrast echocar-diographic study. Circulation 1997; 96 (2): 448–53PubMedCrossRefGoogle Scholar
  52. 52.
    Brochet E, Czitrom D, Karila-Cohen D, Seknadji P, Faraggi M, Benamer H, et al. Early changes in myocardial perfusion patterns after myocardial infarction: relation with contractile reserve and functional recovery. J Am Coll Cardiol 1998; 32 (7): 2011–7PubMedCrossRefGoogle Scholar
  53. 53.
    Braunwald E, Kloner RA. The stunned myocardium: prolonged, postischemic ventricular dysfunction. Circulation 1982; 66 (6): 1146–9PubMedCrossRefGoogle Scholar
  54. 54.
    Cooper HA, Braunwald E. Clinical importance of stunned and hibernating myocardium. Coron Artery Dis 2001; 12 (5): 387–92PubMedCrossRefGoogle Scholar
  55. 55.
    Sakuma T, Otsuka M, Okimoto T, Fujiwara H, Sumii K, Imazu M, et al. Optimal time for predicting myocardial viability after successful primary angioplasty in acute myocardial infarction: a study using myocardial contrast echocardiography. Am J Cardiol 2001; 87 (6): 687–92PubMedCrossRefGoogle Scholar
  56. 56.
    Ragosta M, Camarano G, Kaul S, Powers ER, Sarem-bock IJ, Gimple LW. Microvascular integrity indicates myocellular viability in patients with recent myocardial infarction. New insights using myocardial contrast echocardiography. Circulation 1994; 89 (6): 2562–9PubMedCrossRefGoogle Scholar
  57. 57.
    Main ML, Magalski A, Chee NK, Coen MM, Skolnick DG, Good TH. Full-motion pulse inversion power Doppler contrast echocardiography differentiates stunning from necrosis and predicts recovery of left ventricular function after acute myocardial infarction. J Am Coll Cardiol 2001; 38 (5): 1390–4PubMedCrossRefGoogle Scholar
  58. 58.
    Gibson CM, Cannon CP, Daley WL, Dodge JT, Jr., Alexander B, Jr., Marble SJ, et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 1996; 93 (5): 879–88PubMedCrossRefGoogle Scholar
  59. 59.
    Gibson CM, Cannon CP, Murphy SA, Marble SJ, Barron HV, Braunwald E. Relationship of the TIMI myocardial perfusion grades, flow grades, frame count, and percutaneous coronary intervention to long-term outcomes after thrombolytic administration in acute myocardial infarction. Circulation 2002; 105 (16): 1909–13PubMedCrossRefGoogle Scholar
  60. 60.
    Lepper W, Sieswerda GT, Vanoverschelde JL, Franke A, de Cock CC, Kamp O, et al. Predictive value of markers of myocardial reperfusion in acute myocardial infarction for follow-up left ventricular function. Am J Cardiol 2001; 88 (12): 1358–63PubMedCrossRefGoogle Scholar
  61. 61.
    Greaves K, Dixon SR, Fejka M, O ’Neill WW, Redwood SR, Marber MS, et al. Myocardial contrast echocardiography is superior to other known modalities for assessing myocardial reperfusion after acute myocardial infarction. Heart 2003; 89 (2): 139–44PubMedCrossRefGoogle Scholar
  62. 62.
    Lepper W, Hoffmann R, Kamp O, Franke A, de Cock CC, Kuhl HP, et al. Assessment of myocardial reperfusion by intravenous myocardial contrast echocardiography and coronary flow reserve after primary percutaneous transluminal coronary angioplasty [correction of angiography] in patients with acute myocardial infarction. Circulation 2000; 101 (20): 2368–74PubMedCrossRefGoogle Scholar
  63. 63.
    Jayaweera AR, Wei K, Coggins M, Bin JP, Goodman C, Kaul S. Role of capillaries in determining CBF reserve: new insights using myocardial contrast echocardiography. Am J Physiol 1999; 277(6 Pt 2): H2363–72PubMedGoogle Scholar
  64. 64.
    Iliceto S, Galiuto L, Marchese A, Cavallari D, Colonna P, Biasco G, et al. Analysis of microvascular integrity, contractile reserve, and myocardial viability after acute myocardial infarction by dobutamine echocardiography and myocardial contrast echocardiography. Am J Cardiol 1996; 77 (7): 441–5PubMedCrossRefGoogle Scholar
  65. 65.
    Bolognese L, Antoniucci D, Rovai D, Buonamici P, Cerisano G, Santoro GM, et al. Myocardial contrast echocardiography versus dobutamine echocardiography for predicting functional recovery after acute myocardial infarction treated with primary coronary angioplasty. J Am Coll Cardiol 1996; 28 (7): 1677–83PubMedCrossRefGoogle Scholar
  66. 66.
    Pérez-David E, García-Fernández M, Desco M, Malpica N, Puerta P, Odreman R, et al. Relationship between videointensity parameters, mechanical index and dose evaluated with a new contrast agent. Experimental study in model pigs. Eur Heart J 2001; 22: 221 (Abstract)Google Scholar
  67. 67.
    Wei K, Jayaweera AR, Firoozan S, Linka A, Skyba DM, Kaul S. Quantification of myocardial blood flow with ultrasound-induced destruction of microbubbles administered as a constant venous infusion. Circulation 1998; 97 (5): 473–83PubMedCrossRefGoogle Scholar
  68. 68.
    Masugata H, Peters B, Lafitte S, Strachan GM, Ohmori K, DeMaria AN. Quantitative assessment of myocardial perfusion during graded coronary stenosis by real-time myocardial contrast echo refilling curves.[In Process Citation]. J Am Coll Cardiol 2001; 37 (1): 262–9PubMedCrossRefGoogle Scholar
  69. 69.
    Pérez-David E, García-Fernández M, Ledesma Carbayo M, Silva J, Pérez de Isla L, Antoranz J, et al. Which is the best quantitative method to analyse regional transmural perfusion gradient with real-time myocardial contrast echocardiography? Circulation 2002; 106(19): pp II-676 (Abstract)Google Scholar
  70. 70.
    Shimoni S, Frangogiannis NG, Aggeli CJ, Shan K, Verani MS, Quinones MA, et al. Identification of hibernating myocardium with quantitative intravenous myocardial contrast echocardiography: comparison with dobutamine echocardiography and thallium-201 scintigraphy. Circulation 2003; 107 (4): 538–44PubMedCrossRefGoogle Scholar
  71. 71.
    Desco M, Ledesma Carbayo M, Santos A, García-Fernández M, Marcos-Alberca P, Malpica N, et al. Coherent contrast imaging quantification for myocardial perfusion assessment. Journal of American College 2001;37 (Suppl): 495ACrossRefGoogle Scholar
  72. 72.
    Swinburn JM, Senior R. Real time contrast echocardiography—a new bedside technique to predict contractile reserve early after acute myocardial infarction. Eur J Echocardiogr 2002; 3 (2): 95–9PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • Esther Pérez David
  • Teresa López Fernández
  • José Luis Zamorano
  • Miguel Angel García Fernández

There are no affiliations available

Personalised recommendations