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
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
"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
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SOURCE Mid America Heart Institute of Saint Luke's Hospital of Kansas City