Real-time 3-dimensional echocardiography early after acute myocardial infarction: Incremental value of echo-contrast for assessment of left ventricular function

Gaetano Nucifora, Nina Ajmone Marsan, Eduard R. Holman, Hans Marc J. Siebelink, Jacob M. van Werkhoven, Arthur J. Scholte, Ernst E. van der Wall, Martin J. Schalij, Jeroen J. Bax

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Abstract

Background: Accurate and reproducible assessment of left ventricular (LV) systolic function is important in patients with acute myocardial infarction (AMI). Real-time 3-dimensional echocardiography (RT3DE) is an accurate technique, but it relies heavily on good image quality. The aim of the present study was to evaluate the incremental value of contrast-enhanced RT3DE. Methods: A total of 140 consecutive patients (58 ± 11 years, 78% men) with ST-elevation AMI clinically underwent nonenhanced and contrast-enhanced RT3DE within 24 hours from AMI to evaluate global and regional LV systolic function. Endocardial border definition was graded for each of the 16 LV segments as follows: 0 = border invisible, 1 = border visualized only partially, and 2 = complete visualization of the border. Three image-quality groups (good, fair, and uninterpretable) were identified. Left ventricular volumes and ejection fraction were measured off-line. Wall motion was graded for each visible segment as follows: 1 = normal, 2 = hypokinetic, 3 = akinetic, and 4 = dyskinetic. Results: During contrast-enhanced RT3DE, as compared with nonenhanced RT3DE, the number of segments with complete visualization of the endocardial border increased from 66% to 84% (P < .001); and the number of patients with a good-quality echocardiogram increased from 59% to 94% (P < .001). Intra- and interobserver agreement for assessment of global and regional LV systolic function improved during contrast-enhanced RT3DE, as compared with nonenhanced RT3DE. Conclusions: Assessment of LV systolic function in AMI patients with RT3DE is frequently hampered by suboptimal echocardiographic quality. Contrast-enhanced RT3DE is of incremental value, improving the endocardial border visualization and the reproducibility of LV function assessment.

Original languageEnglish
Pages (from-to)882.e1-882.e8
JournalAmerican Heart Journal
Volume157
Issue number5
DOIs
Publication statusPublished - 1 Jan 2009

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Nucifora, G., Marsan, N. A., Holman, E. R., Siebelink, H. M. J., van Werkhoven, J. M., Scholte, A. J., ... Bax, J. J. (2009). Real-time 3-dimensional echocardiography early after acute myocardial infarction: Incremental value of echo-contrast for assessment of left ventricular function. American Heart Journal, 157(5), 882.e1-882.e8. https://doi.org/10.1016/j.ahj.2009.02.002