Echocardiography with tissue harmonic imaging in the detection of ST segment elevation myocardial infarction: Comparison with coronary angiography

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.