Detection of acute myocardial infarction with digital image processing of two-dimensional echocardiograms

We have previously described the ability of a computer-based image digitizing system to assess early textural changes in acute canine myocardial infarction. To determine whether this technique could be applied to human beings, we studied 12 patients with a first acute transmural myocardial infarction and five normal subjects. Two-dimensional echocardiograms were performed on days 1 and 8 in normal subjects and on days 1 (day of admission), 2, 3, 5, and 14 in the patient population. All recording parameters on the echocardiography machine were kept identical for serial studies. The mean period between hospitalization and first echocardiogram was 11.1 hours (range 4 to 20 hours). End-diastolic frames from the two-dimensional echocardiographic images were digitized and displayed on a monitor. The mean pixel intensity (MPI) (+/- SD) in the region of asynergy (area of myocardial infarction) and a normal area were determined. In normal volunteers, no significant change in MPI was noted between anteroseptal and lateral areas on two separate two-dimensional echocardiographic studies, which were performed 7 days apart (anteroseptal: MPI, 21.6 +/- 1.1 vs 21.8 +/- 0.4, p = not significant) and (lateral: MPI, 21.5 +/- 1.2 vs 21.4 +/- 1.4, p = not significant). In patients with myocardial infarction, a significant increase in MPI was noted on the first day of myocardial infarction between normal and infarcted myocardium (20.4 +/- 2.0 vs 24.3 +/- 2.3, p less than 0.05) and progressively increased thereafter until day 14 (20.5 +/- 1.7 vs 31.9 +/- 3.7, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)