Tissue viability by contrast echocardiography - EHJ Cardiovascular ...

S28 L. Agati et al.
Table 1
Multivariate analysis: Cox regression
Independent LVR predictors
CD1 cut-off 21.7 (HR = 3.75; 95% CI: 1.19–11.80)
TIMI post cut-off 3 (HR = 0.40; 95% CI: 0.17–0.99)
Selecting only TIMI 3 after reperfusion
CD1 cut-off 21.7 (HR = 4.91; 95% CI: 1.32–18.17)
(Table 1). Therefore, contrast defect as compared
to ST-segment reduction after reperfusion more
strongly reflects the efficacy of reperfusion and
it should be used routinely for assessing different
reperfusion strategies. In the subset of patients
reaching TIMI 3 score after reperfusion, multivariate
analysis shows CD extent is the only independent
parameter for LV remodelling (Table 1).
Conclusions
Microvascular damage is the missing link between
LV remodelling infarct size and LV volumes.
After acute myocardial infarction, MCE or MRI
are the ideal methods for (1) assessing residual
tissue viability, (2) following perfusional changes,
and (3) evaluating the efficacy of treatment.
The extent of scar tissue as detected by MRI
or MCE can be considered as a new marker for
identifying patients at high risk for sudden cardiac
death caused by ventricular dysrhytmia, and it
may be used for a better selection of patients as
candidates for ICD implantation.
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