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Assessing Myocardial Viability in Patients with Myocardial Infarction Using Tissue Tracking during Low-dose Dobutamine Stress<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
毕小军 邓又斌 常青 白娇 刘红云 杨好意 黎春雷
Bi Xiaojun, Deng Youbin, Chang Qing, et al
Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030 China
ABSTRACT
Objective：To assess myocardial viability in patients with myocardial infarction by observing the change of the systolic mitral annular displacement(MAD) with tissue tracking(TT) during low-dose dobutamine stress echocardiography(LDDSE).
Methods：Twenty patients with myocardial infarction underwent percutaneous trasluminal coronary angioplasty(PTCA) or PTCA plus stent. LDDSE were performed before operation. The MAD of 6 sites from the apical four chamber, long axis and two chamber views were measured with TT before and after LDDSE and after operation. The change(∆D) and the percent change in MAD induced by LDDSE were measured.
Results：The MAD of the sites corresponding to the infracted myocardium raised at different level at the end of LDDSE in all the patients. But the ∆D（2.2±0.8mm vs 0.5±0.5mm，P＜0.01） and percent change（38%±12% vs 8%±7%，P＜0.01） of MAD were significant higher in the group with viable myocardium than those in the group without viable myocardium. The MAD of the sites corresponding to the infracted myocardium was significantly raised after PTCA in the group with viable myocardium（7.9±2.5mm vs 5.8±2.6mm，P＜0.01）. But in the group without viable myocardium, PTCA did not significantly increase the MAD of the sites corresponding to the infracted myocardium（5.9±2.6mm vs 5.7±2.4mm，P＞0.05）. The sensitivity and specificity of ∆D＞18mm for detecting survived myocardium were 81% and 82%, respectively.
Conclusions：Observing the change of MAD with TT during LDDSE can assess myocardial viability.
KEY WORDS：Tissue tracking Systolic mitral annular displacement Dobutamine Myocardial infarction Myocardial viability | 
