Clinical Usefulness of Myocardial Contrast Echocardiography to Detect Stress-Induced Cardiomyopathy in the Emergency Department

Title
Clinical Usefulness of Myocardial Contrast Echocardiography to Detect Stress-Induced Cardiomyopathy in the Emergency Department
Author(s)
홍그루[홍그루]최정현[최정현]남종호[남종호]손장원이상희김웅박종선신동구김영조
Keywords
APICAL BALLOONING SYNDROME; EMISSION COMPUTED-TOMOGRAPHY; LEFT-VENTRICULAR DYSFUNCTION; TAKOTSUBO CARDIOMYOPATHY; UNITED-STATES; INFARCTION; PERFUSION; TIME; DISEASE; ARTERY
Issue Date
201206
Publisher
JAPANESE CIRCULATION SOC
Citation
CIRCULATION JOURNAL, v.76, no.6, pp.1393 - 1398
Abstract
Background: The purpose of this study was to investigate the clinical usefulness of myocardial contrast echocardiography (MCE) to distinguish stress-induced cardiomyopathy (SCMP) from acute myocardial infarction (AMI) in the emergency department (ED). Methods and Results: We investigated 51 patients (62 13 years, 29 women) who had suspected SCMP in the ED with acute chest pain and showed apical wall motion abnormality on 2-dimensional echocardiography. All patients were assessed by real-time MCE and the perfusion status and quantitative myocardial perfusion parameters were analyzed. After NICE, coronary angiography was performed within 24h. Of 51 patients, 27 had significant perfusion defects (group A) and 24 had preserved perfusion at the apex (group B) by MCE. In group A, 25 patients showed significant luminal stenosis in the left anterior descending artery (LAD) and 2 patients showed no critical luminal stenosis. In group B, 20 patients showed no luminal stenosis and 4 patients showed moderate LAD stenosis. Sensitivity, specificity, positive and negative predictive values of MCE for detection of SCMP were 91%, 86.2%, 83%, and 93%, respectively. Quantitative MCE parameters were significantly decreased in group A compared with group B. Conclusions: Myocardial perfusion measured by MCE is relatively preserved in patients with SCMP compared with those with AMI. Therefore, real-time MCE may be a useful noninvasive diagnostic tool to distinguish SCMP from AMI in the ED. (Circ J 2012; 76: 1393-1398)
URI
http://hdl.handle.net/YU.REPOSITORY/28130http://dx.doi.org/10.1253/circj.CJ-11-1512
ISSN
1346-9843
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의과대학 > 내과학교실 > Articles
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