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Updated: Dec 14, 2025
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Prognostic value of resting myocardial contrast echocardiography: a meta-analysis
Lijun Qian1, Feng Xie2, Di Xu3
1Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Insights
Abnormal resting myocardial perfusion and wall motion imaging in patients with suspected coronary artery disease indicates a higher risk for major adverse cardiac events. This finding is crucial for risk stratification in both emergency and outpatient settings.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Echocardiography
Background:
- Real-time myocardial contrast echocardiography (MCE) enhances detection of coronary artery disease (CAD) through myocardial perfusion (MP) and wall motion (WM) imaging.
- The prognostic value of resting MP and WM in diverse clinical settings (emergency department, outpatient) for CAD requires clarification.
Purpose of the Study:
- To systematically evaluate the prognostic role of resting MP and WM in predicting major adverse cardiac events (MACE) in patients with suspected CAD.
- To assess MACE prediction in both emergency department and outpatient settings.
Main Methods:
- Systematic literature search of PubMed, Embase, and Cochrane Library.
- Meta-analysis of seven studies involving 3668 patients.
- Assessment of diagnostic performance using Summary Receiver Operating Characteristic (SROC) curves.
Main Results:
- Abnormal resting MP and WM significantly predicted MACE (RR, 6.1) and death/nonfatal myocardial infarction (NFMI) (RR, 14.3) compared to normal findings.
- Combined abnormalities were more predictive (RR, 1.7 for MACE; RR, 2.2 for death/NFMI) than isolated WM abnormalities.
Conclusions:
- Combined resting regional MP and WM abnormalities identify the highest-risk patients for adverse cardiac events.
- This combined imaging approach is valuable for risk stratification in suspected CAD across different clinical presentations.
Background:
Resting myocardial perfusion (MP) and wall motion (WM) imaging during real-time myocardial contrast echocardiography (MCE) improves the detection of coronary artery disease (CAD). However, its prognostic role in different clinical settings (emergency department and outpatient setting) remains unclear.
Methods:
A systematic search in PubMed and Embase databases, and the Cochrane library, was conducted to evaluate the role of resting MP and WM in predicting major adverse cardiac events (MACE), including death, nonfatal myocardial infarction (NFMI) and urgent revascularization in patients presenting to either outpatient clinics or emergency departments with suspected symptomatic CAD. Summary receiver operating characteristic (SROC) curves, sensitivity and specificity plots were applied to assess diagnostic performance using RevMan 5.3.
Results:
Seven studies met criteria, including 3668 patients (six with follow up ranging from 2 days to 2.6 years). The Relative Risk (RR) for predicting MACE in patients with both abnormal resting MP and WM was 6.1 (95% CI, 5.1-7.2) and 14.3 (95% CI, 10.3-19.8) for death/NFMI, when compared to normal resting MP and WM patients. Having both abnormal resting MP and WM was also more predictive of MACE (RR, 1.7; 95% CI 1.5-1.9) and death/NFMI (RR, 2.2; 95% CI, 1.8-2.7) when compared to abnormal WM with normal resting MP.
Conclusion:
In this meta-analysis of both ED and outpatient clinic presentations for suspected CAD, having both a resting regional MP and WM abnormality identifies the highest risk patient for adverse events.
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