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Updated: Dec 20, 2025
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Myocardial Contrast Uptake in Relation to Coronary Artery Disease and Prognosis
Hyungseop Kim1, In-Cheol Kim1, Cheol Hyun Lee1
1Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.
Insights
Myocardial contrast uptake (MCU) during left ventricular opacification effectively detects coronary artery disease (CAD). MCU also provides valuable prognostic information for adverse clinical outcomes in patients with suspected CAD.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Echocardiography
Background:
- Myocardial contrast uptake (MCU) during left ventricular opacification (LVO) is a known phenomenon.
- The clinical significance of MCU in diagnosing coronary artery disease (CAD) remains uncertain.
Purpose of the Study:
- To evaluate the diagnostic accuracy of MCU in detecting CAD.
- To assess the prognostic value of MCU for adverse clinical events in patients with known or suspected CAD.
Main Methods:
- Retrospective analysis of contrast echocardiography in 457 patients with prior coronary angiography.
- Classification of MCU patterns (replacement, interstitial, subendocardial).
- Defined primary composite endpoint including acute coronary syndrome, heart failure hospitalization, ventricular tachycardia, and all-cause mortality.
Main Results:
- MCU demonstrated high sensitivity (87.6%) and negative predictive value (87.7%) for CAD detection.
- Specific MCU patterns (replacement, interstitial, subendocardial) were significantly associated with adverse events.
- The presence of MCU provided incremental prognostic value beyond traditional risk factors.
Conclusions:
- Myocardial contrast uptake is a valuable tool for identifying coronary artery disease.
- MCU patterns offer significant prognostic information regarding future adverse clinical outcomes in patients with suspected CAD.
Abstract:
During left ventricular opacification (LVO), myocardial contrast uptake (MCU) is frequently observed, but its clinical implication is uncertain. We aimed to investigate the diagnostic performance of MCU and its prognostic value in known or suspected coronary artery disease (CAD). Contrast echocardiography was retrospectively analyzed in 457 patients who had previous coronary angiography <12 mo before LVO. MCU was classified into replacement or interstitial patterns. Subendocardial patterns were further inspected. Events were defined as a primary composite of the occurrence of acute coronary syndrome, heart failure hospitalization, sustained ventricular tachycardia and all-cause mortality. MCU had an 87.6% sensitivity, 75.5% specificity, 73.0% positive predictive value and 87.7% negative predictive value in detecting CAD. After a median follow-up of 17.3 mo, 52 events occurred. Replacement, interstitial and subendocardial MCU patterns were associated with events. In conclusion, the presence of MCU was useful in identifying CAD and provided incremental prognostic value for clinical outcomes.
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