Assessment of myocardial damage after acute myocardial infarction by diastolic deceleration time of coronary flow velocity using echocardiography and contrast-enhanced magnetic resonance imaging.


Journal

Echocardiography (Mount Kisco, N.Y.)
ISSN: 1540-8175
Titre abrégé: Echocardiography
Pays: United States
ID NLM: 8511187

Informations de publication

Date de publication:
12 2020
Historique:
received: 17 09 2019
revised: 25 09 2020
accepted: 03 10 2020
pubmed: 4 11 2020
medline: 24 6 2021
entrez: 3 11 2020
Statut: ppublish

Résumé

There are limited data available regarding the use of diastolic deceleration time (DDT) of three major arteries measured by transthoracic echocardiography (TTE) for assessing coronary microvascular damage after acute myocardial infarction (AMI). Therefore, we aimed to compare the DDT of three major arteries using TTE with the transmural extent of infarction (TEI) and infarct size, which were classified using contrast-enhanced magnetic resonance imaging (CE-MRI), in patients with AMI. The DDT of the culprit coronary artery was measured in 74 patients using TTE and CE-MRI 1 week after the onset of AMI. The TEI was graded based on the transmural extent of the hyper-enhanced tissue (grades 1-4). The assessable rate for the DDT was 95%; individual rates were 100% for the left anterior descending coronary artery, 90% for the left circumflex artery, and 93% for the right coronary artery. The DDT decreased gradually as the TEI grade progressed (P = .021). Infarct size was significantly correlated with the DDT (r = -0.51, P < .0001). Univariate analysis revealed that the left ventricular (LV) end-systolic volume, LV ejection fraction, and DDT were significantly associated with TEI grade 4. After adjustment via multiple logistic regression analysis, the DDT was independently remained. With a cutoff value of 950ms, as determined by the ROC curve, DDT could detect TEI grade 4 with 81.1% sensitivity and 80.1% specificity. The DDT of three major coronary arteries measured by TTE 1 week after the onset of AMI can assess the extent of myocardial damage, which is determined by CE-MRI.

Sections du résumé

BACKGROUND
There are limited data available regarding the use of diastolic deceleration time (DDT) of three major arteries measured by transthoracic echocardiography (TTE) for assessing coronary microvascular damage after acute myocardial infarction (AMI). Therefore, we aimed to compare the DDT of three major arteries using TTE with the transmural extent of infarction (TEI) and infarct size, which were classified using contrast-enhanced magnetic resonance imaging (CE-MRI), in patients with AMI.
METHODS
The DDT of the culprit coronary artery was measured in 74 patients using TTE and CE-MRI 1 week after the onset of AMI. The TEI was graded based on the transmural extent of the hyper-enhanced tissue (grades 1-4).
RESULTS
The assessable rate for the DDT was 95%; individual rates were 100% for the left anterior descending coronary artery, 90% for the left circumflex artery, and 93% for the right coronary artery. The DDT decreased gradually as the TEI grade progressed (P = .021). Infarct size was significantly correlated with the DDT (r = -0.51, P < .0001). Univariate analysis revealed that the left ventricular (LV) end-systolic volume, LV ejection fraction, and DDT were significantly associated with TEI grade 4. After adjustment via multiple logistic regression analysis, the DDT was independently remained. With a cutoff value of 950ms, as determined by the ROC curve, DDT could detect TEI grade 4 with 81.1% sensitivity and 80.1% specificity.
CONCLUSION
The DDT of three major coronary arteries measured by TTE 1 week after the onset of AMI can assess the extent of myocardial damage, which is determined by CE-MRI.

Identifiants

pubmed: 33140882
doi: 10.1111/echo.14903
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1981-1988

Informations de copyright

© 2020 Wiley Periodicals LLC.

Références

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Auteurs

Sari Imamura (S)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

Kumiko Hirata (K)

Division of Medical Science, Department of Education, Osaka Educational University, Osaka, Japan.

Kazushi Takemoto (K)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

Makoto Orii (M)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

Kunihiro Shimamura (K)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

Yasutsugu Shiono (Y)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

Takashi Tanimoto (T)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

Yoshiki Matsuo (Y)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

Yasushi Ino (Y)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

Hironori Kitabata (H)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

Takashi Kubo (T)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

Atsushi Tanaka (A)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

Takeshi Hozumi (T)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

Takashi Akasaka (T)

Department of Cariology, Wakayama Medical University, Wakayama, Japan.

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