Abstract
The purpose of this study was to investigate the relation of microvascular
integrity and ventricular remodeling after acute myocardial infarction.
Twenty-six patients with first acute anterior myocardial infarction were studied
before discharge with myocardial contrast echocardiography (MCE). Opacification
index (OI) and wall motion index were calculated in the left anterior descending
artery territory and left ventricular diastolic volume was measured at baseline
and during a 9-month follow-up. In total 26 patients, the regional wall motion
improved but the left ventricular volume and global function was not changed
significantly at follow-up. When the patients were divided into 3 groups
according to opacification index (≥0.75, 0.5 approximately 0.75, ≤
0.5) at baseline, functional recovery was not observed and significant left
ventricular dilatation was developed in patients with ≤0.5 OI. Among the
baseline echo-parameters such as ejection fraction, wall motion score, left
ventricular volume and opacification index, the best predictor for long term
left ventricular dilatation was the opacification index by multivariate
analysis. In patients with acute anterior wall infarction the assessment of
microvascular integrity by MCE at acute stage provides useful information
regarding recovery of dysfunctional regional wall motion and ventricular
remodeling.