Myocardial contrast echocardiography (intracoronary application) has emerged as an accurate method to detect the “no-reflow phenomenon.” To investigate the diagnostic value of harmonic angiography after intravenous infusion of Levovist in assessing “no-reflow,” both intracoronary and intravenous contrast injections were performed in a group of patients with acute myocardial infarction. Seventeen consecutive patients with a successfully reperfused acute myocardial infarction within 6 hours of symptom onset were selected for this study. All patients underwent contrast echocardiography with harmonic angiography with Levovist (400 mg/mL, intravenous pump infusion, trigger intervals 1:4 to 1:8) and sonicated albumin (0.5 to 1 mL, intracoronary bolus) on day 1 after the achievement of a sustained coronary reflow. Myocardial perfusion was qualitatively assessed with a 12-segment model. The endocardial length of the residual contrast defect after reflow was also calculated. Forty-four of 204 segments were not analyzed after intravenous contrast echocardiography and 37 after intracoronary contrast echocardiography because of artifacts. Intracoronary and intravenous injections showed a perfusion defect in 31 (19%) segments, with a concordance of 89% (κ coefficient, 0.72). Concordance in anteroseptal, anterolateral, and inferolateral segments was 95% (κ = 0.92), 88% (κ = 0.66), and 83% (κ = 0.57), respectively. With intracoronary injection used as the reference method, intravenous injection had a sensitivity of 74% and a specificity of 93% for diagnosing contrast defects. The endocardial extent of no-reflow was 18 ± 19 after intravenous and 21 ± 17 after intracoronary contrast echocardiography (P = not significant). Intravenous contrast echocardiography with Levovist reliably identifies the no-reflow phenomenon after successful reperfusion, especially in acute anteroseptal myocardial infarction. (J Am Soc Echocardiogr 2001;14:773-81.)

Assessment of no reflow phenomenon after acute myocardial infarction using harmonic angio and intravenous pump infusion with Levovist: comparison with intracoronary contrast injection / Agati, Luciano; Funaro, S; Bilotta, F.. - In: JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY. - ISSN 0894-7317. - 14:(2001), pp. 773-781. [10.1067/mje.2001.113235]

Assessment of no reflow phenomenon after acute myocardial infarction using harmonic angio and intravenous pump infusion with Levovist: comparison with intracoronary contrast injection

AGATI, Luciano;BILOTTA F.
2001

Abstract

Myocardial contrast echocardiography (intracoronary application) has emerged as an accurate method to detect the “no-reflow phenomenon.” To investigate the diagnostic value of harmonic angiography after intravenous infusion of Levovist in assessing “no-reflow,” both intracoronary and intravenous contrast injections were performed in a group of patients with acute myocardial infarction. Seventeen consecutive patients with a successfully reperfused acute myocardial infarction within 6 hours of symptom onset were selected for this study. All patients underwent contrast echocardiography with harmonic angiography with Levovist (400 mg/mL, intravenous pump infusion, trigger intervals 1:4 to 1:8) and sonicated albumin (0.5 to 1 mL, intracoronary bolus) on day 1 after the achievement of a sustained coronary reflow. Myocardial perfusion was qualitatively assessed with a 12-segment model. The endocardial length of the residual contrast defect after reflow was also calculated. Forty-four of 204 segments were not analyzed after intravenous contrast echocardiography and 37 after intracoronary contrast echocardiography because of artifacts. Intracoronary and intravenous injections showed a perfusion defect in 31 (19%) segments, with a concordance of 89% (κ coefficient, 0.72). Concordance in anteroseptal, anterolateral, and inferolateral segments was 95% (κ = 0.92), 88% (κ = 0.66), and 83% (κ = 0.57), respectively. With intracoronary injection used as the reference method, intravenous injection had a sensitivity of 74% and a specificity of 93% for diagnosing contrast defects. The endocardial extent of no-reflow was 18 ± 19 after intravenous and 21 ± 17 after intracoronary contrast echocardiography (P = not significant). Intravenous contrast echocardiography with Levovist reliably identifies the no-reflow phenomenon after successful reperfusion, especially in acute anteroseptal myocardial infarction. (J Am Soc Echocardiogr 2001;14:773-81.)
01 Pubblicazione su rivista::01a Articolo in rivista
Assessment of no reflow phenomenon after acute myocardial infarction using harmonic angio and intravenous pump infusion with Levovist: comparison with intracoronary contrast injection / Agati, Luciano; Funaro, S; Bilotta, F.. - In: JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY. - ISSN 0894-7317. - 14:(2001), pp. 773-781. [10.1067/mje.2001.113235]
File allegati a questo prodotto
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/79046
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 30
  • ???jsp.display-item.citation.isi??? 20
social impact