Mid America Heart Institute Reports on New Test for Measuring Damage After Heart Attack

    KANSAS CITY, Mo., Sept. 17 /PRNewswire/ -- A report by physicians from the
 Mid America Heart Institute in Kansas City discloses a new method for
 evaluating damage caused by a heart attack in today's issue of the Journal of
 the American College of Cardiology.  The report, "Combined Assessment of
 Microvascular Integrity and Contractile Reserve Improves Differentiation of
 Stunning and Necrosis After Acute Anterior Wall Myocardial Infarction,"
 compares the accuracy of a new technique, myocardial contrast echocardiography
 (MCE), with the reference standard test, low-dose dobutamine echocardiography
 (LDDE).
     Residual cardiac function is a primary determinant of survival after a
 heart attack.  MCE utilizes cardiac ultrasound and an intravenous injection of
 "microbubbles" which act as red blood cell tracers.  Regions of the heart that
 are irreversibly damaged show no contrast effect, while areas that will
 eventually recover function are contrast enhanced.
     Study results showed that for each measure of diagnostic utility (i.e.,
 sensitivity, specificity, positive and negative predictive values and overall
 accuracy), the new test, MCE, performed at least as well as LDDE, with MCE
 showing higher sensitivity.  In addition, the study indicated that when MCE
 and LDDE test results were in agreement (for 74 percent of the heart segments
 studied), those concordant results further enhanced overall diagnostic
 accuracy following a heart attack.
     According to Michael L. Main, M.D., lead author, MCE has advantages over
 LDDE.
     "The reference standard LDDE technique is time-consuming and
 interpretation is difficult," Main says.  "Additionally, LDDE cannot be
 performed in patients already receiving inotropic support, or exhibiting
 complex ventricular arrhythmias.  In contrast, MCE studies can be easily and
 safely performed at the bedside in critically ill patients to determine
 whether heart muscle will recover function."
     Although other techniques for assessing myocardial viability are
 available, investigators say they believe either MCE or LDDE, or a combination
 of the two techniques, will be favored in most hospitals based on the high
 diagnostic accuracy, widespread availability, portability, lack of radiation
 exposure, and the relatively low cost.
     Mid America Heart Institute is the area's premier cardiovascular center
 and is a member of Saint Luke's-Shawnee Mission Health System.  The Heart
 Institute is widely recognized for its quality of patient care and
 accomplishments in education, research, and the development of new
 technologies.
 
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SOURCE Mid America Heart Institute of Saint Luke's Hospital of Kansas City

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