Circulation, Vol 62, 1248-1255, Copyright © 1980 by American Heart Association
JV Nixon, KA Narahara and TC Smitherman
To determine whether real-time two-dimensional echocardiography (2-D echo)
can estimate the extent of myocardial involvement in patients with acute
myocardial infarction (MI), regional wall motion on serial short-axis 2-D
echo recordings was analyzed and the summed scores were compared with
estimates of infarct involvement by thallium-201 reperfusion (Tl) and
technetium-99m stannous pyrophosphate (99mTc-PYP) scintigraphy. Thirty-two
consecutive male patients admitted with their first MI were studied; 10
patients had anterior, 16 had inferior and six had subendocardial MIs. Two
patients were technically unsuitable for 2-D echo studies. Twenty patients
had Tl scintigrams and 29 had 99MTc-PYP scintigrams. Summed 2-D echo scores
correlated closely with estimates of infarct involvement by Tl (r = 0.87)
and with estimates of infarct size by 99mTc-PYP (r = 0.74). The location of
MI by 2-D echo agreed with the electrocardiographic location in 26 of 29
patients; discrepancies occurred in one inferior and two subendocardial
MIs. Predischarge 2-D echo failed to identify extension of transmural
infarction. However, two patients whose subendocardial MIs progressed to
transmural MIs were identified. This study shows that 2-D echo is a valid
method for the early estimation of the extent of myocardial involvement in
patients with acute MI, especially transmural MIs. In particular, 2-D echo
correlates closely with Tl reperfusion scintigraphy because both detect
areas of ischemia and infarction.
ARTICLES
Estimation of myocardial involvement in patients with acute myocardial infarction by two-dimensional echocardiography
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