Concordancia de la motilidad segmentaria evaluada por ecocardiograma transtorácico y resonancia magnética cardíaca en pacientes con infarto agudo de miocardio
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Fecha
2018-10
Autores
Cadena-Bonfanti, Alberto
González-Torres, Henry J.
Valdes-Casas, Bayron
Ruiz-Pla, Fabián
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Editor
Sociedad Colombiana de Cardiología & Cirugía Cardiovascular
Resumen
Introducción: La evaluación de la contractilidad segmentaria es un marcador importante para
determinar la extensión de la enfermedad coronaria manifestada a través de un evento isquémico
cardiaco. La resonancia magnética cardíaca es el patrón estándar para evaluar dicha
motilidad; sin embargo, debido al elevado número de exámenes, la disponibilidad de equipos
de resonancia magnética y el costo de los exámenes de resonancia magnética, el uso del
ecocardiograma transtorácico es el método diagnóstico de elección.
Objetivo: Evaluar la concordancia de la evaluación de la motilidad de diferentes segmentos
miocárdicos y de agrupación de segmentos por territorios de irrigación arterial obtenidos por
resonancia magnética cardiaca y ecocardiograma transtorácico en pacientes hospitalizados por
infarto agudo de miocardio.
Métodos: A un grupo de pacientes que llegaron al servicio de emergencia por infarto agudo
de miocardio, se les realizó ecocardiograma transtorácico y resonancia magnética cardiaca y
se compararon los resultados. La resonancia magnética cardiaca fue el valor de referencia a
comparar para fracción de eyección y contractilidad segmentaria. Las pruebas comparativas
se hicieron a un 95% de confianza mediante el coeficiente de Kappa-Cohen para evaluar la
concordancia entre las medidas.
Resultados: No se encontraron diferencias entre la fracción de eyección del ventrículo izquierdo
medida por ecocardiograma transtorácico y resonancia magnética cardiaca. Los territorios irrigados
por las arterias coronarias descendente anterior y circunfleja tenían una concordancia
mediana y buena. En aquellos asociados con la arteria coronaria derecha la concordancia fue
baja y media.
Introduction: The evaluation of segmental contractility is an important marker to determine the extent of the coronary disease manifested by an ischaemic event. Cardiac magnetic resonance is the standard pattern to evaluate this contractility. However, due to lower availability of magnetic resonance equipment, as well as the increased cost of magnetic resonance tests, the use of the transthoracic echocardiogram is the diagnostic method of choice. Objective: The aim of the study is to compare the evaluation of the motility of different myocardial segments and segments grouped by coronary artery supply territories obtained by cardiac magnetic resonance and transthoracic electrocardiogram performed on patients admitted to hospital with acute myocardial infarction. Methods: A cardiac magnetic resonance and transthoracic electrocardiogram was performed on a group of patients that arrived in the Emergency Department due to an acute myocardial infarction, and the results were compared. The cardiac magnetic resonance was the reference value to compare for the ejection fraction and segmental contractility. Comparative tests were performed with 95% confidence limits using a Kappa-Cohen coefficient to evaluate the agreement between the measurements. Results: No differences were found between the left ventricular ejection fraction measured by cardiac magnetic resonance and transthoracic electrocardiogram. There was average and good agreement in the coronary and circumflex artery supply territories, respectively. In those associated with the right coronary artery, the concordance was low and average. Conclusions: There was no difference between the evaluation of the ejection fraction by transthoracic electrocardiogram or that by cardiac magnetic resonance. In the evaluation of segmental motility, cardiac magnetic resonance was better than transthoracic electrocardiogram.
Introduction: The evaluation of segmental contractility is an important marker to determine the extent of the coronary disease manifested by an ischaemic event. Cardiac magnetic resonance is the standard pattern to evaluate this contractility. However, due to lower availability of magnetic resonance equipment, as well as the increased cost of magnetic resonance tests, the use of the transthoracic echocardiogram is the diagnostic method of choice. Objective: The aim of the study is to compare the evaluation of the motility of different myocardial segments and segments grouped by coronary artery supply territories obtained by cardiac magnetic resonance and transthoracic electrocardiogram performed on patients admitted to hospital with acute myocardial infarction. Methods: A cardiac magnetic resonance and transthoracic electrocardiogram was performed on a group of patients that arrived in the Emergency Department due to an acute myocardial infarction, and the results were compared. The cardiac magnetic resonance was the reference value to compare for the ejection fraction and segmental contractility. Comparative tests were performed with 95% confidence limits using a Kappa-Cohen coefficient to evaluate the agreement between the measurements. Results: No differences were found between the left ventricular ejection fraction measured by cardiac magnetic resonance and transthoracic electrocardiogram. There was average and good agreement in the coronary and circumflex artery supply territories, respectively. In those associated with the right coronary artery, the concordance was low and average. Conclusions: There was no difference between the evaluation of the ejection fraction by transthoracic electrocardiogram or that by cardiac magnetic resonance. In the evaluation of segmental motility, cardiac magnetic resonance was better than transthoracic electrocardiogram.
Descripción
Palabras clave
Ecocardiografía, Resonancia magnética cardíaca, Infarto agudo de miocardio, Transthoracic
echocardiogram, Cardiac magnetic
resonance, Acute myocardial
infarction