Comparison of multislice spiral computed tomography and stress echocardiography in the evaluation of myocardial viability in patients with acute myocardial infarction].

T N Veselova, V N Shitov, V V Vlodzianovskiĭ, I N Merkulova, E B Iarovaia, S K Ternovoĭ, M Ia Ruda

Vestnik rentgenologii i radiologii 2011 Sep-Oct

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The purpose of the investigation was to analyze the data of 64-multislice spiral computed tomography (MSCT-64) versus those of low-dose dobutamine echocardiography (stress EchoCG) used to diagnose the viable myocardium in patients with acute myocardial infarction (AMI). The investigation enrolled 49 patients with AIM. Contrast-enhanced MSCT-64 and low-dose dubutamine stress EchoCG were performed in patients in the early periods of AMI. The viable myocardium was examined in 780 segments of the left ventricle (LV). The data of delayed MSCT and stress EchoCG agreed in 759 (97.3%) segments, did not in 21 (2.7%) segments; Cohen's kappa coefficient was 0.88. The affected segment index (As index) was introduced into the investigation, which is an integral indicator of the number of segments with perfusion defect and nonviable segments detected by MSCT. There was a statistically significant correlation of the As index with the asynergy index (r = 0.91; p = 0.000) and LV ejection fraction (r = -0.75; p = 0.000). Our previous study has demonstrated that MSCT-64 is an informative method to evaluate myocardial viability; the signs of myocardial perfusion and structural derangements can serve as predictors of diminished LV contractility.

Citation

T N Veselova, V N Shitov, V V Vlodzianovskiĭ, I N Merkulova, E B Iarovaia, S K Ternovoĭ, M Ia Ruda. Comparison of multislice spiral computed tomography and stress echocardiography in the evaluation of myocardial viability in patients with acute myocardial infarction]. Vestnik rentgenologii i radiologii. 2011 Sep-Oct(4):24-30