Microvascular Damage Evaluated By Myocardial Contrast Echocardiography In Patients With Myocardial Infarction

Objective: To evaluate the microvascular damage with qualitative and quantitative myocardial contrast echocardiography(MCE) and assess the relationship with gensini score of epicardium vessel obtained by coronary angiography in patients with myocardial infarction. Methods: Thirty- five patients with first myocardial infarction were examined by myocardial contrast echocardiogarphy before revascularized after hospitalization. Coronary angiography was performed and infarction related artery were revascularized in all patients.We estimated LV function with ejection fraction(EF) and wall motion score index(WMSI). Qualitative perfusion score(PSI) and quantitation value of A,?, and A×? of myocardial segments were obtained from microbubble replenishment curves y(t) = A·(1-exp-?t) + C in myocardial contrast imaging. We assessed mean intima- media thickness of bilateral common carotid artery(CCD-IMT) in all patients at the same time. Gensini score was calculated from coronary angiography. Correlations between EF, WMSI, PSI, CCD-IMT and Gensini score were analysed. Results: 589 segments which can be visibled in thirty- five patients were distinguished into three groups(normal perfusion group, nonuniform perfusion group, perfusion defect group)due to qualitative analysis in MCE images. Quantitative analysis between the three groups were significantly different in A, ? and A×?. Spearman relation between EF,WMSI, PSI and Gensini score were-0.536?0.580?0.508 respectively(p<0.05). Spearman relation between EF, WMSI and PSI were-0.751?0.859 respectively(p<0.05). Spearman relation between WMSI and EF was-0.845(p<0.05). Spearman relation between CCD-IMT and Gensini score was 0.227(p>0.05). Conclutions: The relationship between quantitative MCE perfusion score and EF, WMSI were higer than Gensini score with WMSI and EF. Q uantitative MC E analysis indicated obvious difference in three various qualitative perfusion groups. Qualitative perfusion score and quantitative analysis demonstrated damage level of myocardial microcirculation in patients with myocardial infarction and showed a good accordance. CCD-IMT had no obvious correlattion with Gensini score.