Dwivedi Girish, Janardhanan Rajesh, Hayat Sajad A, Lim Tiong K, Senior Roxy
Department of Cardiovascular Medicine, Northwick Park Hospital, Northwick Park Institute of Medical Research, Harrow, UK.
Eur J Echocardiogr. 2009 Dec;10(8):933-40. doi: 10.1093/ejechocard/jep099. Epub 2009 Aug 4.
Contrast echocardiography has been shown to be a more accurate method of assessing left ventricular (LV) remodelling compared with unenhanced echocardiography after acute myocardial infarction (AMI). However, whether this translated into improved prediction of outcome is not known.
Accordingly, a total of 89 consecutive patients undergoing contrast echocardiography and unenhanced echocardiography 7 to 10 days after AMI and reperfusion therapy were followed up for cardiac death (CD) and AMI. LV ejection fraction (LVEF), LV end-systolic volume (ESV), and LV end-diastolic volume were assessed by the two methods independently. Outcome data were obtained (mean 46 +/- 16 months).There were 15 (17%) events (eight CDs and seven AMIs). LVEF and ESV with contrast echocardiography were found to be independent multivariable predictors of CD (P = 0.04 and P = 0.02, respectively) and CD or AMI (P = 0.02 and P = 0.01, respectively). Furthermore, LVEF and ESV with contrast echocardiography provided incremental information for the prediction of CD (P = 0.004 and P = 0.004, respectively) and CD or AMI (P = 0.02 and P = 0.03, respectively).
Contrast echocardiography provided improved prediction of outcome compared with unenhanced echocardiography following AMI.
与急性心肌梗死（AMI）后未增强的超声心动图相比，对比增强超声心动图已被证明是评估左心室（LV）重构的更准确方法。然而，这是否转化为对预后的更好预测尚不清楚。
因此，对89例在AMI和再灌注治疗后7至10天接受对比增强超声心动图和未增强超声心动图检查的连续患者进行随访，观察心源性死亡（CD）和AMI情况。两种方法分别独立评估左心室射血分数（LVEF）、左心室收缩末期容积（ESV）和左心室舒张末期容积。获得结局数据（平均46±16个月）。有15例（17%）事件（8例心源性死亡和7例AMI）。发现对比增强超声心动图测得的LVEF和ESV是心源性死亡的独立多变量预测因子（分别为P = 0.04和P = 0.02）以及心源性死亡或AMI的独立多变量预测因子（分别为P = 0.02和P = 0.01）。此外，对比增强超声心动图测得的LVEF和ESV为心源性死亡（分别为P = 0.004和P = 0.004）以及心源性死亡或AMI（分别为P = 0.02和P = 0.03）的预测提供了增量信息。
与AMI后未增强的超声心动图相比，对比增强超声心动图对预后的预测更佳。
