Myocardial contrast echocardiography predicts left ventricular remodelling after acute myocardial infarction

Background: We investigated whether the extent of residual myocardial viability demonstrated by myocardial contrast echocardiography (MCE) predicts the degree of left ventricular (LV) remodelling after acute myocardial infarction as assessed by cardiovascular magnetic resonance. Methods. Accordingly, 2 5 patients underwent MCE 5 to 7 days after acute myocardial infarction followed by cardiovascular magnetic resonance assessment of LV end-diastolic volume, LV end-systolic volume, and LV ejection fraction. A contrast perfusion index was calculated within the infarct-related territory. Results: LV end-diastolic and end-systolic volumes were significantly smaller (138 +/- 38 vs 188 +/- 43 mL, P = .008, and 86 +/- 35 vs 119 +/- 49 mL, P = .01, respectively) and LV ejection fraction was significantly higher (52 +/- 5.4 vs 31.5 +/- 3.2%, P = .02) in patients showing good myocardial viability (contrast perfusion index less than or equal to 1.5) compared with those without viability. MCE was the only multivariate predictor of LV volumes and LV ejection fraction at 2 weeks and 6 months. Conclusions: The extent of residual myocardial viability as demonstrated by MCE predicts the degree of LV remodelling after acute myocardial infarction.