Full-motion pulse inversion power Doppler contrast echocardiography differentiates stunning from necrosis and predicts recovery of left ventricular function after acute myocardial infarction

J Am Coll Cardiol. 2001 Nov 1;38(5):1390-4. doi: 10.1016/s0735-1097(01)01574-1.


Objectives: The goal of this study was to determine, in patients with a recent myocardial infarction (MI) and residual wall motion abnormalities within the distribution of the infarct-related artery, whether normal perfusion by myocardial contrast echocardiography (MCE) would accurately predict recovery of segmental left ventricular (LV) function.

Background: Left ventricular dysfunction after acute MI may be secondary to myocardial stunning or necrosis. Recent technical innovations in contrast echocardiography, including pulse inversion imaging and power Doppler, now allow full-motion echocardiographic perfusion assessment from a venous injection of fluorocarbon-based contrast agent.

Methods: Thirty-four patients with recent MI underwent baseline wall motion assessment and MCE two days after admission and follow-up echocardiography a mean of 55 days later.

Results: Perfusion by MCE predicted recovery of segmental function with a sensitivity of 77%, specificity of 83%, positive predictive value of 90% and overall accuracy of 79%. The mean wall motion score at follow-up was significantly better in perfused, compared with nonperfused, segments (1.4 vs. 2.2, p < 0.0001). Additionally, 90% of perfused segments improved, while the majority of nonperfused segments remained unchanged.

Conclusions: Full-motion MCE utilizing an intravenous fluorocarbon-based agent and pulse inversion power Doppler techniques, identifies stunned myocardium, and accurately predicts recovery of segmental LV function in patients with recent MI.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Albumins
  • Angioplasty, Balloon, Coronary
  • Coronary Angiography
  • Diagnosis, Differential
  • Echocardiography, Doppler / instrumentation
  • Echocardiography, Doppler / methods*
  • Echocardiography, Doppler / standards*
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Fluorocarbons
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Myocardial Infarction / pathology
  • Myocardial Infarction / therapy
  • Myocardial Stunning / diagnostic imaging*
  • Myocardial Stunning / etiology*
  • Myocardial Stunning / pathology
  • Necrosis
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Recovery of Function
  • Single-Blind Method
  • Treatment Outcome
  • Triiodobenzoic Acids
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / etiology*
  • Ventricular Dysfunction, Left / pathology


  • Albumins
  • FS 069
  • Fibrinolytic Agents
  • Fluorocarbons
  • Triiodobenzoic Acids
  • iodixanol