P1018Safety and accuracy of early two-dimensional and three-dimensional echocardiographic myocardial perfusion analysis at patients with acute myocardial infarction.

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The aim of the study was to assess the value of myocardial perfusion (MCE) analysis at patients (pts) referred to echocardiographic assessment after acute myocardial infarction (STEMI). The part of the assessment was to analyze the safety of the procedure in the case of three-dimensional perfusion assessment. According to coronary angiography consecutive patients after first myocardial infarction treated by PCI were referred to 2 arms of the study– first (group 1) pts with AMI complicated by no-reflow phenomena - 45 (51%), second (group 2) – pts with no no-reflow phenomena 43 (49%). All pts received standard medical therapy according to the European guidelines. The infarct related artery was LAD in 41 pts (47%), RCA 24 (27%) and Cx 20 (26%). Finally, 3 pts (3%) of pts were excluded from MCE because of technical conditions. The MCE-2D were performed using commercially available stabilized sulphur hexafluoride in slow intravenous infusion and recorded in 20-cycles low-mechanical index mode. In first 2 seconds of recordings 3 seconds of flash with high-mechanical index was used for microbubles destruction. The MCE-3D data were recorded in 7-cycles full volume mode after 3 seconds manual flash. After 1 week and 6 months rest echo and dobutamine stress echo were performed at 84 pts to confirm primary assessment. The safety of MCE were assessed by occurrence of clinical, echocardiographical and electrocardiographical monitoring during the test and after 30-day period. Conclusions: MCE is safe procedure even at patients within 24 first hours after myocardial infarction. Diagnostic specificity of MCE is higher at pts without no-reflow phenomena.

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