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European Journal of Echocardiography 2004 5(3):189-195; doi:10.1016/S1525-2167(03)00080-5
© 2004 by European Society of Cardiology
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Copyright © 2003, The European Society of Cardiology

Effect of harmonic imaging on the measurement of ultrasonic integrated backscatter and its interpretation in patients following myocardial infarction

J.E Hancock*, J.C Cooke and M.J Monaghan

Cardiology Department, King's College Hospital, London, UK

Received 30 January 2003; received in revised form 25 July 2003; accepted after revision 28 July 2003.

* Corresponding author. Cardiology Department, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK. Tel.: +44-161-291-2624; fax: +44-161-291-2389. janehancock{at}hotmail.com


  Abstract

Background: Recently, we have demonstrated that cyclic variation in ultrasonic integrated backscatter (IBS) can be used to predict patency of the infarct related artery (IRA) post-acute myocardial infarction (AMI). Second harmonic imaging has become widely available on ultrasound machines and enhances endocardial definition. The effect of harmonic imaging on the measurement and interpretation of cyclic IBS is unknown.

Methods and results: Twenty-eight patients were studied post-AMI. Cyclic IBS was measured in myocardial segments supplied by the IRA as well as in remote segments with normal myocardial function in both fundamental and second harmonic modes. Harmonic imaging increased the measurement of cyclic IBS in IRA as well as normal myocardial territories. However, the difference in cyclic IBS between IRA and normal myocardial territories remained unchanged.

Conclusion: Second harmonic imaging increases the measurement of cyclic IBS. However, the interpretation of these data is unchanged in the setting of AMI. It is important that repeated studies in the same patient are performed in the same mode (fundamental or harmonic) as the values are not interchangeable.

Keywords: harmonic imaging; integrated backscatter; myocardial infarction


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