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Updated: Aug 20, 2026
Ultrasonic Assessment of Myocardial Microstructure
Published on: January 14, 2014
Sensitive detection of myocardial viability in chronic coronary artery disease by ultrasonic integrated backscatter
Kaoru Komuro1, Satoshi Yamada, Taisei Mikami
1Department of Cardiovascular Medicine, Hokkaido University, Sapporo 060-8638, Japan.
Insights
Magnitude of cyclic variation of integrated backscatter (MVIB) better reflects myocardial viability than contractile reserve in patients with chronic coronary artery disease. This ultrasonic tissue characterization is a sensitive method for detecting myocardial viability.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Myocardial viability and contractile reserve are distinct concepts in dysfunctional heart segments.
- The utility of ultrasonic tissue characterization using phase-corrected magnitude of cyclic variation of integrated backscatter (MVIB) in chronic coronary artery disease requires further validation.
- Distinguishing between MVIB's reflection of contractile reserve versus myocardial viability in chronically dysfunctional myocardium is crucial.
Purpose of the Study:
- To determine whether MVIB predominantly reflects contractile reserve or myocardial viability in chronically dysfunctional myocardium.
- To validate the use of ultrasonic tissue characterization for assessing myocardial function in chronic coronary artery disease.
Main Methods:
- MVIB measurements were performed on severely dysfunctional myocardial segments in 34 patients with prior myocardial infarction.
- Dobutamine stress echocardiography was used to assess contractile reserve.
- Fluorine-18 fluorodeoxyglucose positron emission tomography served as the gold standard for evaluating myocardial viability.
Main Results:
- MVIB was significantly higher in segments with contractile reserve compared to those without (P < .0001), but with considerable overlap.
- MVIB showed distinct differences between segments with and without myocardial viability (P < .0001).
- MVIB accurately predicted myocardial viability with 92% sensitivity and 94% specificity.
Conclusions:
- For patients with chronic coronary artery disease, MVIB is a more accurate indicator of myocardial viability than contractile reserve.
- Ultrasonic tissue characterization using MVIB, when correlated with fluorine-18 fluorodeoxyglucose positron emission tomography, offers a sensitive approach for detecting myocardial viability.
Background:
Myocardial viability is not synonymous with contractile reserve and identifiable in a significant percentage of dysfunctional myocardial segments without contractile reserve. The usefulness of ultrasonic tissue characterization by the phase-corrected magnitude of cyclic variation of integrated backscatter (MVIB) in chronic coronary artery disease is not fully validated. Thus, whether MVIB predominantly reflects the contractile reserve or myocardial viability of chronically dysfunctional myocardium was determined.
Methods:
The MVIB of severely dysfunctional interventricular septum or posterior wall was measured in 34 consecutive patients with previous myocardial infarction. Dobutamine stress echocardiography and fluorine-18 fluorodeoxyglucose positron emission tomography were used as the standards of contractile reserve and myocardial viability, respectively.
Results:
Among 44 dysfunctional segments, only 15 were judged as having contractile reserve and 29 were judged as not by dobutamine stress echocardiography, whereas 26 segments showed myocardial viability using fluorine-18 fluorodeoxyglucose positron emission tomography and 18 did not. MVIB was greater in segments with than in those without contractile reserve (4.7 +/- 2.2 vs -1.4 +/- 4.9 dB, P < .0001), but there was considerable overlap between the groups. On the other hand, MVIB of segments with and without myocardial viability (4.1 +/- 2.6 vs -4.3 +/- 3.3 dB, P < .0001) was distinctly different and predicted myocardial viability with a sensitivity of 92% and a specificity of 94%.
Conclusions:
For patients with chronic coronary artery disease, MVIB better reflects myocardial viability than it does contractile reserve. Ultrasonic tissue characterization, in concordance with fluorine-18 fluorodeoxyglucose positron emission tomography, is a sensitive method for detecting myocardial viability.
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