R Senior

..PSE is a novel technique for evaluating myocardial perfusion. RAMP (real-time assessment of myocardial perfusion)-1 and -2 were international, Phase 3 trials that evaluated the ability of PSE with Imagify, to detect CAD...

..This article provides an overview of Imagify, a new ultrasound contrast agent...

..Based on the evidence, recommendations are proposed for the clinical use of contrast echocardiography...

..To assess ethnic differences in the prevalence and aetiology of left ventricular systolic dysfunction (LVSD) in the community...

..Contrast agents therefore have a significant role in cardiovascular diagnostics and its use can only improve patient care...

..The aim of the study was to assess the feasibility of a new technique, power Doppler harmonic imaging (PDHI), for assessing myocardial perfusion through a venous injection of microbubbles, with the use of a new ultrasound contrast agent...

..Improvement in LV geometry contributes to better LV systolic function, which in turn is the best predictor of survival after revascularization...

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..However, its value for the prediction of mortality in patients referred for suspected heart failure (HF) is unknown...

..N-terminal pro-B type natriuretic peptide (NTpBNP) is a potential marker of cardiac failure...

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..This may reflect differing underlying hemodynamic mechanisms of hypertension in these age groups...

..CONCLUSION: DSE is a powerful predictor of outcome in stable survivors of AMI. The presence of myocardial viability has a positive impact on survival...

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..CONCLUSIONS: Intravenous delayed triggered MCE can independently detect myocardial viability early after AMI...

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..Its very high negative predictive values would allow their use in future community-based screening programmes...

..Dobutamine stress echocardiography has emerged as a safe and valuable technique for the assessment of myocardial viability and for the selection of patients for revascularization...

..Intravenous contrast echocardiography, however, revealed typical features of hypertrophic apical cardiomyopathy. Thus contrast echocardiography may be used to establish the diagnosis of this condition...

..But improvements in image quality and use of predefined reading criteria are necessary to improve interobserver agreement further in myocardial regions where conformity in dobutamine stress echocardiographic interpretation is low...

..However, the routine use of ambulatory blood pressure monitoring is not currently recommended, mainly because of a lack of outcome trials based on the treatment of ambulatory blood pressure levels. (c)2001 by Le Jacq Communications, Inc...

..Values in excess of these should be viewed with caution and should prompt further investigation to identify the underlying mechanism...

..It was concluded that SonoVue is safe and effective in delineating endocardial border, including in patients with suboptimal baseline images...

..These beneficial effects on remodeling may help to explain the relative prognostic benefits of these therapies...

..89) with NT-proBNP values approximately 5 times greater than BNP (Biosite Triage). In a subset of 320 with normal ejection fraction (>50%) and no risk factors, NT-proBNP values increased with age and were higher in women than men...

..Recent studies have demonstrated the role of MCE to evaluate the value of perfusion and function during rest and dobutamine stress echo in patients early after AMI in terms of risk stratification and management of these patients...

..CONCLUSIONS: MCE is currently the best and most accurate measure of reperfusion at a microvascular level and an excellent predictor of left ventricular function at one month following acute myocardial infarction...

..As a result contrast enhanced echocardiography may become the gold-standard in the assessment of wall motion and LV function...

..Tissue Doppler imaging allows quantitation of wall motion. Ready availability and reliability makes stress echocardiography a cost effective technique for the assessment of CAD...

..Investigation of the mechanisms underlying the pathogenesis of LV remodeling and blood pressure etiology may help redress the excess CVD mortality observed in Indian Asians...

..This technique has the potential to provide a bedside assessment of myocardial viability...

..This review focuses on the role of non-invasive testing for myocardial viability in patients with left ventricular systolic dysfunction and heart failure and also outlines the pros and cons of each technique...

..001). CONCLUSION: This suggests that vasodilator stress is not optimally suited for use with techniques that use regional wall thickening abnormality as a marker of ischemia for the diagnosis of coronary artery disease...

..Myocardial contrast echocardiography is equally adept in assessing chronic coronary artery disease, acute coronary syndromes and hibernating myocardium...

..Stress echocardiography and regional wall motion assessment. Future echocardiography will be more 3D and more quantitative than current echocardiography. And contrast echocardiography has already proven its value for both applications...

..Inhibition of iPF2alpha-III has no effect on coronary flow or infarct size in the murine heart, suggesting that iPF2alpha-III alone does not account for the low/no reflow phenomenon observed following AMI...

..0003). In conclusion, stress MCE was superior to TIMI risk score and exercise electrocardiography in the assessment of risk in patients with suspected acute coronary syndrome, nondiagnostic electrocardiogram, and negative troponin...

..CONCLUSIONS: A normal stress echocardiogram portends an excellent prognosis, even in a cohort with a high proportion of patients having intermediate or high pre-test probability of coronary artery disease...

..1, 95% confidence interval 1.43 to 85.6, p = 0.02). In conclusion, NT-pro-BNP and abnormal echocardiogram provided independent information for predicting adverse outcome in patients with suspected HF referred from the community...

..Its portability, rapid acquisition and interpretation of data, and the absence of radiation exposure make it an ideal bedside technique...

..Thus, hand-held echocardiography devices accurately assessed LVH and may be used for community-based screening for LVH in targeted patients with hypertension...

..This technique may be utilized to reliably predict late recovery of function in dysfunctional myocardium after AMI...

..002) were the only independent predictors of recovery of function. Thus, for optimum prediction of recovery of function after AMI, a combination of DE and MCE in dobutamine nonresponsive segments may be utilized...

..Whether midwall shortening is depressed in physiological hypertrophy is unknown...

..Nitrate-enhanced perfusion imaging has been shown to detect viability in dysfunctional myocardium, but nitrate-enhanced technetium 99m sestamibi has not been compared with nitrate-enhanced thallium 201...

..We sought to determine the clinical and economic impact of stress echocardiography (SEcho) when compared with exercise ECG (ExECG) in the assessment of these patients...

..Although MCE has been primarily performed for medical research, its implementation in routine clinical care is evolving. This article is intended to give an overview of the current status of MCE...

..CONCLUSIONS: Use of MCE accurately predicted significant IRA stenosis and MVD after thrombolysis. This information is valuable for identifying patients who may benefit from mechanical revascularization...

..001) and myocardial blood flow (P = .001) assessed by MCE. CONCLUSION: MCE reflects the transmural extent of AMI as assessed by CMR. Both techniques predict contractile reserve...

..SE significantly reduces the requirement for further tests to diagnose CAD compared to ExECG...

..The aim of the study was to assess whether myocardial contrast echocardiography (MCE) can identify underlying coronary artery disease (CAD) as the cause of AHF...

..66 with CMR) compared with HE (agreement, 69%; kappa = 0.33 with CMR). CONCLUSIONS: Low-power CE is more accurate than HE for estimating LV remodeling after AMI...

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..MCE was the only multivariate predictor of global recovery of function and CR (OR=3.5, p=0.01). The different physiological mechanisms employed by MCE and SPECT translate into different relative accuracies for the detection of MV...

..Use of contrast in such difficult to image patients is very useful in establishing a correct diagnosis...

..However, MCE is significantly more accurate in predicting >50% of the transmural extent of infarction and more sensitive in identifying <or=25% of the transmural extent of infarction than SPECT...

..Furthermore, its use is not limited solely to diagnostic assessment. Preliminary evidence suggests that targeted microbubbles may be useful in enhancing delivery of genes / drugs and in clot lysis...

..It has comparable accuracy with other non-invasive imaging techniques, such as dobutamine stress echocardiography, radionuclide scintigraphy and cardiac magnetic resonance imaging...

..CONCLUSIONS: The extent of residual myocardial viability as demonstrated by MCE predicts the degree of LV remodelling after acute myocardial infarction...

..This study sought to determine whether residual myocardial viability determined by myocardial contrast echocardiography (MCE) after acute myocardial infarction (AMI) can predict hard cardiac events...