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Improving the quality of life and reducing sudden cardiac death by limiting the impact of heart rhythm disturbances.
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In much the same way as wall thickening is graded using a numerical score and then divided by the number of segments to yield the Wall Motion Scoring Index (WMSI), the pattern of contrast uptake in myocardial segments can also be numerically scored.
An example of a semi-quantitative scoring system would be:
The scores for each segment are summed and then divided by the number of segments to yield a CONTRAST PERFUSION INDEX (CPI).
At rest, this score clearly also is linked to myocardial viability (lack of contrast uptake implies lack of an intact microvasculature which usually implies scar tissue) – a CPI>1.5 has been shown to correlate with a low likelihood of viable myocardium.
If the CPI is calculated at rest and after stress, the difference between the two represents the ISCHAEMIC BURDEN of myocardium.
7. Jeetley P, Swinburn J, Hickman M, Bellenger NG, Pennell DJ, Senior R. Myocardial contrast echocardiography predicts left ventricular remodelling after acute myocardial infarction. J Am Soc Echocardiogr 2004;17(10):1030-6
8. Dwivedi G, Janardhanan R, Hayat SA, Swinburn JM, Senior R. Prognostic value of myocardial viability detected by myocardial contrast echocardiography early after acute myocardial infarction. J Am Coll Cardiol 2007;50(4):327-34
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