Ultrasonic Tissue Characterization: Review of a Noninvasive Technique for Assessing Myocardial Viability
Stuart O. Schecter1, Louis E. Teichholz, Victor Klig
1St. Francis Arrythmia Center, 100 Port Washington Blvd., Roslyn, NY 11576.
Insights
Ultrasonic tissue characterization shows promise for bedside assessment of salvageable myocardium during acute coronary syndromes. This technique may offer a practical alternative to current imaging methods for determining myocardial viability.
Area of Science:
- Cardiology
- Medical Imaging
- Ultrasound Technology
Background:
- Assessing myocardial perfusion and viability is crucial for treatment decisions in coronary artery disease.
- Current noninvasive methods like PET, SPECT, and MRI are effective but impractical for acute settings.
- Rapidly distinguishing viable from nonviable myocardium is essential for timely reperfusion therapy to limit infarct size.
Purpose of the Study:
- To explore the potential of ultrasonic tissue characterization as a bedside tool for identifying salvageable myocardium.
- To evaluate the feasibility of using ultrasound for rapid assessment of myocardial viability in acute coronary syndromes.
Main Methods:
- Review of existing evidence on ultrasonic tissue characterization for myocardial assessment.
- Comparison of ultrasound's potential advantages against established imaging modalities (PET, SPECT, MRI).
Main Results:
- Ultrasonic tissue characterization demonstrates significant potential as a practical bedside diagnostic tool.
- This technique could aid in the search for salvageable myocardium in acute settings.
Conclusions:
- Ultrasonic tissue characterization may become a valuable tool for bedside assessment of myocardial viability.
- Further clinical studies are needed to fully understand ultrasound's interaction with myocardium and optimize its application.
Abstract:
The determination of myocardial perfusion and myocardial viability has prognostic and therapeutic implications, particularly in the current era of percutaneous transluminal coronary angioplasty and thrombolytic therapy. Several modes of investigation, including positron emission tomography, thallium-201 scintigraphy, and nuclear magnetic resonance imaging are used to differentiate viable from nonviable myocardium. Though these noninvasive tests are useful diagnostic modalities, they are expensive, time consuming, and too cumbersome to be used in the acute setting. Expeditious distinction between viable and nonviable myocardium, during acute coronary syndromes, is of great importance since reperfusion can minimize the extent of ischemic injury and infarction. An expanding body of evidence confirms that ultrasonic tissue characterization has great potential to become a practical bedside diagnostic tool in the search for salvageable myocardium. Further clinical investigative studies would help accomplish a better understanding of the complex interaction between ultrasound and myocardium. (ECHOCARDIOGRAPHY, Volume 13, July 1996)
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