Evaluation Of Percutaneous Coronary Intervention Clinical Effect By Detecting Viable Myocardium Through Myocardial Contrast Echocardiography

Objective: To evaluate viable myocardium in acute myocardial infarction(AMI) patients by real-time myocardial contrast echocardiography (RTMCE). To investigate therapeutic effects between drug treatment and percutaneous coronary intervention (PCI) .Methods: 31 patients with acute myocardial infarction were divided into drug treatment group and PCI group,Echocardiography and real-time myocardial contrast echocardiography was used to detect value of myocardial reperfusion before treatment and 1 month after treatment respectively . According to the degree of contrast medium filling rate, and myocardial blood flow observed scintigraphy reperfusion conditions, with quantitative analysis of cardiac ultrasound (CUSQ) software on myocardial blood flow reperfusion time- density curve shape of a myocardial imaging and the related peak intensity (A), curve rose to a plateau, the average slope (β) and regional myocardial blood flow (A ?β) value analysis, observation on before and after treatment .To assess the situation of viable myocardium infarct with the indicator of myocardial blood flow reserve ratio of the value of that change; and observe for 1 month of major adverse cardiac events including sudden cardiac death, heart failure worsen , malignant arrhythmia (monomorphic ventricular tachycardia, polymorphic ventricular tachycardia, ventricular flutter or ventricular fibrillation),so as to assess the prognosis of different treatment regimen.Results: Real-time myocardial contrast echocardiography predict myocardial viability with a sensitivity of 88.37%, specificity 67.7%, accuracy 86.6%, compared with two-dimensional echocardiography can more accurately predict the survival of myocardial infarction. There is no significant difference between the treatment of short-term of drug and PCI in acute myocardial infarction. The imaging time of myocardial perfusion showed no improvement ( P> 0.05 ) in myocardial scintigraphy ultrasound. Micro-bubble break again in 10 cases of drug treatment group before and after treatment. The infusion time shortened after PCI.In 20 cases of PCI group, suggesting improved myocardial perfusion, and P <0.01. CSI was increased from 1.58±0.17 to 1.63±0.25 when before and 1 month after treatment in 10 cases of drug treatment group , but show no significant difference. The CSI of PCI group was increased from 1.50±0.39 to 1.72±0.17 after 1 month of treatment by PCI, P <0.01. A.βshow no significant difference in Drug treatment group before and after treatment. But A ?βbefore and after treatment were 1.45±0.54,1.56±0.52, P<0.05. PCI group before treatment A,βwas 1.09±0.25,1.38±0.27, after treatment 1.51±0.33,1.66±0.23, prompt reperfusion curve up to speed, the platform was increased, and there was statistically significant, P <0.01 . And A ?βbefore and after treatment were 1.56±0.63, 2.88±0.9, suggest increased myocardial reserve, and was statistically significant P <0.01.Conclusion: Real-time myocardial contrast echocardiography may be used to assess myocardial perfusion qualitatively and quantitatively.Coronary stenting can effectively prompt micro-perfusion in patients with myocardial infarction. There is no significantly difference in clinic outcome between the treatment of short-term of drug treatment and PCI in acute myocardial infarction.