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Clinical validity of longitudinal pre-ejectional myocardial velocity for identifying the transmural extent of viable myocardium: early after reperfusion of an infarct-related coronary artery

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Authors
Kim, Hyung-Kwan; Kim, Yong-Jin; Chang, Sung-A; Kim, Song-Yi; Jang, Ho-Joon; Lee, Whal; Park, Jin-Shik; Sohn, Dae-Won; Oh, Byung-Hee; Park, Young-Bae; Choi, Yun-Shik
Issue Date
2007-11-27
Publisher
Unknown / The Japanese Circulation Society
Citation
Circ J. 2007 Dec;71(12):1904-11.
Keywords
AdultAgedBlood Flow Velocity/physiologyCoronary Vessels/*physiopathology/ultrasonographyEchocardiography, Doppler/*methodsFemaleHumansMagnetic Resonance Imaging/*methodsMaleMiddle AgedMyocardial Infarction/*physiopathology/*ultrasonography*Myocardial ReperfusionPredictive Value of TestsProspective StudiesReproducibility of ResultsSensitivity and SpecificityStroke Volume/*physiology
Abstract
BACKGROUND: Positive longitudinal pre-ejectional velocity (+PEVL) was recently reported to be a reliable index of myocardial recovery early after successful revascularization in myocardial infarction (MI); that is, it recognizes the transmural extent of viable myocardium. The applicability of PEVL in the real-world clinical setting for identifying the transmural extent of viable myocardium in reperfused recent MI was assessed. METHODS AND RESULTS: Using tissue Doppler imaging, the resting basal and mid myocardial PEVLs were determined within 3 days after revascularization in 41 consecutive patients with recent MI. Infarct thickness was semi-quantified using delayed gadolinium-enhanced magnetic resonance imaging (MRI) at baseline and at 6-month follow up to differentiate transmural from nontransmural MI. The proportion of segments showing the presence of +PEVL was not significantly changed as infarct thickness increased (p=0.2), with 66.2% having +PEVL even in segments involving >75% transmural infarction. Moreover, +PEVL was found in a large fraction of segments with akinesia (70.4%). Specificity and negative predictive value of +PEVL for assessing infarct nontransmurality were disappointingly low (32.0% and 26.9%, respectively). All of these results were not altered when the 6-month follow-up MRI was done. CONCLUSIONS: +PEVL cannot be regarded as a reliable marker for predicting the transmural extent of viable myocardium in recent MI.
ISSN
1346-9843 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18037744

http://hdl.handle.net/10371/18415
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College of Medicine/School of Medicine (의과대학/대학원)Emergency Medicine (응급의학전공)Journal Papers (저널논문_응급의학전공)
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