Evaluation Of Myocardial Microcirculation Perfusion In AMI Patients Using Myocardial Contrast Echocardiography

Objective: To assess the value of myocardial contrast echocardiography (MCE) in evaluating myocardial microcirculation perfusion in acute myocardial infarction (AMI) patients and variation of myocardial microcirculation perfusion before and after elective percutaneous coronary intervention (PCI).Methods: Twenty-four patients with first suffering AMI who had not had the opportunities of primary and rescue PCI were examined by MCE, using SonoVue intravenous injection, intermittent trigger and second harmonic imaging (IHI). Within 2 days, they were performed PCI. Within two days after PCI they were performed MCE again. 20 patients among them were treated successfully by PCI. Adopting the method of dividing left ventricle into 16 segments, we quantified the peak intensity (PI) and the area under curve (AUC) at papillary muscle level in short-axis view of left ventricle by acoustic densitometry (AD). Left ventricular myocardial segments of all patients were divided into 4 groups according to the degree of coronary artery stenosis (<50%, 50%～69%. 70%～89%, 3≥90%), determined by coronary artery angiography. Acoustic density parameters were compared among these groups, and the correlation between these parameters and the degree of coronary artery stenosis was performed by correlation analysis. The differences of parameters in normal perfused and infarct-related segments of 20 patients were also analyzed before and after PCI.Results: All patients were examined by MCE successfully and no side effects were found. The PI (9.34±2.42, 8.15±2.17, 3.21±0.74, 2.07±0.46) and AUC (935.47 ±245.94,687.40±194.47,400.85±98.04,245.76±55.75) among the 4 groups were significantly different (F =106.47, 82.42, all P<0.001), But PI and AUC of every group were poorly correlated with the degree of coronary artery stenosis (r =－0.29,...