Ultrasonic tissue characterization predicts left ventricular remodeling in patients with acute anterior myocardial infarction after primary coronary angioplasty

Objectives: The aim of this study was to assess the role of cyclic variation (CV) of myocardial integrated backscatter (IBS) in the prediction of left ventricular (LV) remodeling in patients with anterior acute myocardial infarction (AMI) after primary coronary angioplasty. Background: Some studies have shown that the CV of myocardial IBS predicts myocardial viability for patients with AMI Methods: We recorded short-axis IBS images within 24 hours of angioplasty in 80 patients with anterior AMI Two parameters were measured: the magnitude of CV and the normalized time delay (NTD). The increase in LV end-diastolic volume (LVEDV) at 4 weeks (Delta LVEDV) was defined as LV remodeling (> 20% increase from baseline). Results: Patients were divided into two groups according to LV remodeling status: the remodeling group (n = 41) and the nonremodeling group (n = 39). There was a significant difference in the magnitude of CV between the two groups (5.11 +/- 1.47 vs 5.96 +/- 189 dB, P <.05), and the NTD was significantly different in the two groups (1.57 +/- 0.31 vs 1.23 +/- 0.32, P <.0001). The correlation between the magnitude of CV and Delta LVEDV was significant but weak (r = -0.338, P <.01). There was significant correlation between NTD and Delta LVEDV (r = 0.443, P <.0001). Using NTD greater than 1.35 as the optimal cutoff, the sensitivity, specificity, and positive and negative predictive values to predict LV remodeling were 82%, 86%, 87%, and 80%, respectively. Conclusions: Myocardial IBS, especially NTD, is useful for predicting LV remodeling in patients with AMI after primary coronary angioplasty.