PMID- 27546353
OWN - NLM
STAT- MEDLINE
DCOM- 20170713
LR  - 20170817
IS  - 1540-8175 (Electronic)
IS  - 0742-2822 (Linking)
VI  - 33
IP  - 10
DP  - 2016 Oct
TI  - A comparison of infarct mass by cardiac magnetic resonance and real time 
      myocardial perfusion echocardiography as predictors of major adverse cardiac 
      events following reperfusion for ST elevation myocardial infarction.
PG  - 1539-1545
LID - 10.1111/echo.13308 [doi]
AB  - PURPOSE: Infarct mass as assessed by myocardial-delayed enhancement imaging on 
      cardiac magnetic resonance (CMR) and myocardial blood flow as assessed by real 
      time myocardial perfusion echocardiography (RT-MPE) have been shown to predict 
      adverse events following ST elevation myocardial infarction (STEMI). There has 
      been no published comparison of quantitative assessment using these modalities as 
      predictors of clinical outcomes to date. We compared RT-MPE with CMR for 
      prediction of cardiac events in reperfused STEMI patients. MATERIALS AND METHODS: 
      Consecutive STEMI patients with early reperfusion were studied. RT-MPE and CMR 
      were performed. Perfusion score indices (PSI(RT)(-)(MPE) and PSI(CMR) ) were 
      calculated [sum of segmental perfusion scores/number of segments]. CMR infarct 
      mass (g) and RT-MPE myocardial blood flow (MBF dB/s) were quantified. Patients 
      were followed for cardiac events (death, nonfatal MI, revascularization, angina, 
      and heart failure). RESULTS: All 27 patients (age 62+/-14; follow-up 3.5+/-2.6 years) 
      had thrombolysis in myocardial infarction (TIMI) grade 3 flow of infarct vessel. 
      Cardiac events occurred in 17 (63%). Cardiac event patients had higher 
      PSI(RT)(-)(MPE) , PSI(CMR) , infarct mass, and lower MBF. PSI(RT)(-)(MPE) cutoff 
      of 0.3 had an AUC of 0.856 (82% sensitivity, 70% specificity), while a PSI(CMR) 
      cutoff of 0.2 had an AUC of 0.765 (76% sensitivity, 60% specificity). Infarct 
      mass and MBF were independent predictors of cardiac events after adjusting for 
      risk factors (hazard ratios: 20.9 [95% CI 1.8-256] P=.02 and 8.1 [95% CI 1.5-78] 
      P=.01, respectively). CONCLUSIONS: Quantitative RT-MPE performed comparably to 
      CMR for prediction of MACE in STEMI patients supporting a prognostic role for 
      this noninvasive, bedside imaging method.
CI  - (c) 2016, Wiley Periodicals, Inc.
FAU - Lenz, Charles J
AU  - Lenz CJ
AD  - Department of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, 
      Minnesota.
FAU - Abdelmoneim, Sahar S
AU  - Abdelmoneim SS
AD  - Department of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, 
      Minnesota.
FAU - Anavekar, Nandan S
AU  - Anavekar NS
AD  - Department of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, 
      Minnesota.
AD  - Department of Radiology, Mayo Clinic Rochester, Rochester, Minnesota.
FAU - Foley, Thomas A
AU  - Foley TA
AD  - Department of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, 
      Minnesota.
AD  - Department of Radiology, Mayo Clinic Rochester, Rochester, Minnesota.
FAU - Nhola, Lara F
AU  - Nhola LF
AD  - Department of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, 
      Minnesota.
FAU - Huang, Runqing
AU  - Huang R
AD  - Department of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, 
      Minnesota.
FAU - Oh, Jae K
AU  - Oh JK
AD  - Department of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, 
      Minnesota.
FAU - Mulvagh, Sharon L
AU  - Mulvagh SL
AD  - Department of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, 
      Minnesota. smulvagh@mayo.edu.
LA  - eng
PT  - Controlled Clinical Trial
PT  - Journal Article
DEP - 20160821
PL  - United States
TA  - Echocardiography
JT  - Echocardiography (Mount Kisco, N.Y.)
JID - 8511187
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Comorbidity
MH  - Echocardiography/*methods
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Minnesota/epidemiology
MH  - Myocardial Infarction/*diagnostic imaging/mortality/*surgery
MH  - Myocardial Perfusion Imaging/*methods
MH  - Myocardial Revascularization/*mortality
MH  - Prevalence
MH  - Reproducibility of Results
MH  - Risk Factors
MH  - Sensitivity and Specificity
MH  - Survival Rate
MH  - Treatment Outcome
OTO - NOTNLM
OT  - ST elevation myocardial infarction
OT  - major adverse cardiac events
OT  - microvascular obstruction
OT  - outcomes research
OT  - perfusion imaging
OT  - prognosis
EDAT- 2016/10/27 06:00
MHDA- 2017/07/14 06:00
CRDT- 2016/08/23 06:00
PHST- 2016/10/27 06:00 [pubmed]
PHST- 2017/07/14 06:00 [medline]
PHST- 2016/08/23 06:00 [entrez]
AID - 10.1111/echo.13308 [doi]
PST - ppublish
SO  - Echocardiography. 2016 Oct;33(10):1539-1545. doi: 10.1111/echo.13308. Epub 2016 
      Aug 21.