Scar Detection by Pulse-Cancellation Echocardiography Validation by CMR in Patients With Recent STEMI

JACC-CARDIOVASCULAR IMAGING

卷:9

Article

Gaibazzi, Nicola¹  Bianconcini, Michele¹  Marziliano, Nicola²  Parrini, Iris³  Conte, Maria Rosa³  Siniscalchi, Carmine¹  Faden, Giacomo⁴  Faggiano, Pompilio⁵  Pigazzani, Filippo¹  Grassi, Francesca¹  Albertini, Lisa¹ 

[1] Parma Univ Hosp, Via Gramsci 14, I-43123 Parma, Italy

[2] UOC Cardiol ASL3 Osped San Francesco, Nuoro, Italy

[3] Mauriziano Hosp, Turin, Italy

[4] Poliambulanza Hosp, Brescia, Italy

[5] Brescia Civili Univ Hosp, Brescia, Italy

关键词: cardiac magnetic resonance;    echocardiography;    late gadolinium enhancement;    myocardial infarction;    scar;   

DOI  :  10.1016/j.jcmg.2016.01.021

来源: Elsevier

【 摘 要 】

OBJECTIVES This study sought to assess an echocardiographic approach (scar imaging echocardiography with ultrasound multipulse scheme [eSCAR]), based on existing multipulse ultrasound scheme, as a marker of myocardial scar in humans, compared with cardiac magnetic resonance assessing late gadolinium enhancement (CMR-LGE). BACKGROUND The detection of myocardial scar impacts patient prognosis and management in coronary artery disease and other types of cardiac disease. The clinical experience with echocardiography suggests that the reflected ultrasound signal is often significantly enhanced in infarcted myocardial segments. METHODS Twenty patients with a recent ST-segment elevation myocardial infarction (STEMI) (cases) and 15 patients with absent CMR-LGE (negative controls) were imaged with both the eSCAR pulse-cancellation echocardiography and CMR-LGE to assess their potential association. RESULTS Scar was detectable at CMR-LGE in 19 of 20 STEMI patients (91%), whereas all (100%) demonstrated eSCAR at echocardiography. In the 19 STEMI patients in whom CMR-LGE was detected, regional matching between eSCAR and CMR-LGE was total, although the segmental extent of detected scar was not always superimposable, particularly in the most apical segments, a region in which eSCAR demonstrated undersensitivity for the true extent of scar. CONCLUSIONS A 2-dimensional multipulse echocardiography allows detection of myocardial scar, reliably matching the presence and site of CMR-LGE at 30 days after STEMI, or its absence in negative controls. (C) 2016 by the American College of Cardiology Foundation.

【 授权许可】

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