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Echocardiography offers the future for infarct size quantification
Date:12/7/2011

"Up until now infarct size has only been measured as part of clinical studies and not in routine clinical practice. The reason being that the reference method of gadolinium based contrast agents in MRI is expensive, takes a great deal of time to perform, and can only be undertaken by imaging specialists," explains EAE president Dr Luigi Badano, from the University of Padua, Italy. "The advantages of STE over MRI is that it's far quicker to use, cheaper, and can be used by cardiologists at the bedside with portable machines, and repeated serially when ever needed."

Additionally, STE can be applied even in patients with contraindications for MRI, such as metallic devices, claustrophobia, and severe renal failure that preclude use of contrast infusions. "The studies presented here open the way for every patient who is admitted to hospital with STEMI to undergo assessment of infarct size with echocardiography prior to discharge," says Badano.

Infarct size matters for determining how well patients will recover from STEMI. Statistics suggest that people who suffer damage to more than 30% of the left ventricle are twice as likely to die within a year of the event than people who suffer less damage. "It's well known that patients with larger infarcts are more likely to undergo alterations in the structure (dimensions, mass and shape) of the left ventricle, known as cardiac remodelling, which leads to heart failure," says Badano.

Evidence is mounting, he adds, that screening for patients with larger infract sizes enables identification of patients with a worse prognosis who benefit from more aggressive therapy and more frequent follow-up visits. "Nowadays many more options exist for STEMI patients deemed at high risk of adverse events, including prescription of ACE inhibitors and insertion of devices like CRT cardiac resynchronisation or ICDs", says Badano.

Speckle tracking echocardiography (STE) is a comparatively new non-invasive
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Contact: ESC Press Office
press@escardio.org
33-049-294-8627
European Society of Cardiology
Source:Eurekalert

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