Využití akustické denzitometrie v hodnocení viability myokardu u nemocných s chronickou ischemickou chorobou srdeční

Title in English Application od acoustic densitometry in assessment of myocardial viability in patients with coronary artery disease
Authors

PANOVSKÝ Roman MELUZÍN Jaroslav KINCL Vladimír FISCHEROVÁ Blanka ŠTĚTKA František ČERNÝ Jan

Year of publication 2003
Type Article in Periodical
Magazine / Source Cor et Vasa
MU Faculty or unit

Faculty of Medicine

Citation
Field Cardiovascular diseases incl. cardiosurgery
Keywords acoustic densitometry; viability; coronary artery disease
Description Aim: The purpose of our study was to assess whether acoustic densitometry could distinguish between viable and irreversible dysfunctional myocardium in patients with coronary artery disease before myocardial revascularization. Methods: Seventy patients with chronic coronary artery disease and dysfunctional myocardial segments before planned myocardial revascularization were examined by acoustic densitometry. Fifty four patients had revascularization of at least one coronary artery supplying dysfunctional segments. Control echocardiography of these patients was performed after 3 months after bypass surgery or percutaneous coronary intervention for assessing contractility of revascularized, initially dysfunctional myocardial segments. The dysfunctional segments were defined as viable if they exhibited improvement in their thickening after revascularization. Wall motion was scored using 16-segment model of left ventricle, acoustic densitometry was evaluated from parasternal long axis view, parasternal short axis view at the level of papilary muscles and apical four-chamber and two-chamber views. Amplitude of cyclic variation of integrated backscatter (CVIB) was evaluated from each dysfunctional segment. Optimal cut off value of CVIB for distinction between viable and irreversible dysfunctional myocardium was found using receiver operating characteristic curves. Results: Cut off values for anteroseptal, posterior, interventricular septal, lateral, inferior and anterior segments were 4,1; 4,3; 4,4; 4,2; 4,5; 4,0 and 4,2 decibels, respectively. Sensitivity, specificity, positive and negative predictive values for identification of myocardial viability by acoustic densitometry using this cut off values were 91%, 81%, 87%, and 86%, respectively. Conclusion: Acoustic densitometry can differentiate viable and irreversible dysfunctional myocardium in patients with coronary artery disease before myocardial revascularization.
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