Echocardiography with tissue harmonic imaging in the detection of st segment elevation myocardial infarction:
Li Yang1, Wei Wu, Jingfeng Wang
1Department of Cardiology, Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. lyc.yang@tom.com
Insights
Tissue harmonic imaging (THI) effectively detects acute myocardial infarction in ST-elevation patients. This echocardiography technique aids in identifying infarct locations, though certain sites require careful observation.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Tissue harmonic imaging (THI) enhances echocardiogram quality for better cardiac visualization.
- Its utility in detecting acute myocardial infarction (AMI) remains under-explored.
Purpose of the Study:
- To evaluate the effectiveness of THI in diagnosing ST-elevation myocardial infarction (STEMI).
- To assess the accuracy of THI in localizing myocardial infarcts.
Main Methods:
- Ninety-eight patients with first STEMI underwent THI and coronary angiography.
- Echocardiogram findings from THI were compared with coronary angiography results.
Main Results:
- THI provided adequate echocardiogram quality in 95.9% of patients.
- Myocardial infarction was detected by THI in 92.9% of cases.
- THI accurately identified infarct locations, correlating with coronary angiography findings (88.8% accuracy).
Conclusions:
- Echocardiography with THI is a sensitive method for STEMI detection.
- Careful examination of inferior, posterior wall, or right ventricle infarcts is crucial to prevent missed diagnoses.
Background:
Tissue harmonic imaging (THI) has been used to improve endocardial border definition and cardiac structure visualization in patients with poor quality echocardiograms. However, little is known about the usefulness of THI in the detection of acute myocardial infarction.
Methods:
Ninety-eight patients with a first ST segment elevation myocardial infarction were investigated using THI and coronary angiography.
Results:
Using THI, adequate quality echocardiograms were obtained in 95.9% of the patients. THI detected myocardial infarction in 92.9% of the patients. The sites of myocardial infarction estimated by THI and echocardiogram were nearly consistent. The sites of myocardial infarction estimated by THI were in accordance with the territories subtended by the infarct-related artery in coronary angiography (accuracy 88.8%), among which the highest accuracy (96.8%) concerning infarcts caused by left anterior descending branch disease. Infarcts involving inferior, posterior wall, or right ventricle were commonly complicated with myocardial infarction of other location, and were more likely to be missed.
Conclusions:
Echocardiography with THI is a sensitive technique for detecting ST segment elevation myocardial infarction. More attention should be paid to the observation of inferior, posterior wall, or right ventricle to avoid missing the detection of myocardial infarction involving these sites.
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