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Surveillance of adenosine stress myocardial contrast echocardiography following percutaneous coronary intervention

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Abstract

Background

The ability of adenosine stress myocardial contrast echocardiography (AS-MCE) to reveal decreased coronary blood flow or perfusion defects (PDs) has not been explored for clinical implications after coronary revascularization. This study sought to identify the prognostic value of PDs in asymptomatic patients following percutaneous coronary intervention (PCI).

Methods

We retrospectively analyzed 342 asymptomatic patients (67 years of mean age, 72% male) who underwent PCI with stents at least 9 months before AS-MCE between May 2019 and December 2020. Resting regional wall motion abnormality (rRWMA) and the patterns of PDs were assessed, and further PDs were classified as ischemic or fixed type. The primary endpoint was the composite of hospitalization for worsening heart failure, coronary revascularization, and cardiac death.

Results

In AS-MCE (median time interval following PCI: 17.4 months), PDs were present in 93 (27.2%) out of 342 patients; 70 of ischemic PD (75.3%), 58 of fixed PD (62.4%). Those with PD showed a higher frequency of rRWMA than those without PD (53.8 vs. 15.7%, p < 0.001). During the median follow-up of 22.6 months, 26 (7.6%) patients experienced more associated clinical outcomes with PD than rRWMA. Cox analysis revealed that the combined findings of rRWMA and PD, and specifically, ischemic PD of ≥ 2 segments were associated with a high increase in adverse outcomes.

Conclusions

AS-MCE provided prognostic value in asymptomatic patients with prior PCI. PD might be complementary to rRWMA in risk stratification.

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Acknowledgements

This work was supported by the research promoting grant from the Keimyung University Dongsan Medical Center in 2020.

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, 1035 Dalgubeol-daero, Dalseo-gu, 42601, Daegu, Republic of Korea

    Hyungseop Kim MD, PhD., In-Cheol Kim MD, PhD, Jongmin Hwang MD, PhD, Hyoung-Seob Park MD, PhD, Cheol Hyun Lee MD, PhD, Yun-Kyeong Cho MD, PhD, Hyuck-Jun Yoon MD, PhD, Chang-Wook Nam MD, PhD, Seongwook Han MD, PhD & Seung-Ho Hur MD, PhD

Authors
  1. Hyungseop Kim MD, PhD.
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  2. In-Cheol Kim MD, PhD
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  4. Hyoung-Seob Park MD, PhD
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  5. Cheol Hyun Lee MD, PhD
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  6. Yun-Kyeong Cho MD, PhD
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  7. Hyuck-Jun Yoon MD, PhD
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  8. Chang-Wook Nam MD, PhD
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  9. Seongwook Han MD, PhD
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Contributions

All authors approved the final article and declared their contributions to the article as following, Hyungseop Kim, In-Cheol Kim: Conceptualization, Methodology, Writing-Original Draft, Writing-Review & Editing. Hyuck-Jun Yoon, Jongmin Hwang: Software, Validation, Investigation, Data Curation, Writing-Review & Editing. Hyoung-Seob Park: Conceptualization, Methodology, Writing-Original Draft, Writing-Review & Editing. Cheol Hyun Lee, Yun-Kyeong Cho: Software, Formal analysis. Chang-Wook Nam, Seongwook Han: Resources, Visualization. Seung-Ho Hur: Writing-Review & Editing, Supervision.

Corresponding author

Correspondence to Hyungseop Kim MD, PhD..

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Ethics approval:

This study was approved by the institutional review board of Keimyung University Dongsan Medical Center (Reference No. 2019-06-031) and conformed to the ethical guidelines of the Declaration of Helsinki.

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Kim, H., Kim, IC., Hwang, J. et al. Surveillance of adenosine stress myocardial contrast echocardiography following percutaneous coronary intervention. Int J Cardiovasc Imaging 38, 1909–1918 (2022). https://doi.org/10.1007/s10554-022-02583-2

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