Development of real-time two-dimensional ultrasonic myocardial tissue characterization to assess myocardial molecular characteristics.

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We clarified that indexes derived from ultrasonic myocardial tissue characterization well reflected myocardial molecular characteristics and myocardial fibrosis in animal studies. A clinical study with patients with myocardial infarction has demonstrated that the ultrasonic indexes correlated with myocardial viability assessed with myocardial scintigraphy. In addition, the transmural trend of the indexes was different between patients with transmural myocardial infarction and those with non-transmural infarction. A study with patients with dilated cardiomyopathy showed that 75% of the patients had abnormal indexes at rest, and that the indexes at rest correlated with the degree of myocardial fibrosis assessed by myocardial histology. In the patients whose indexes at rest were not abnormal, the indexes provided abnormal responses to dobutamine stress test as compared with normal subjects. The current results suggest that ultrasonic myocardial tissue characterization is useful in non-invasive and cost-effective assessment of myocardial viability and the degree of fibrosis, ad that its clinical utility is likely to be enhanced by a combination with some stress tests. Future studies remain necessary to establish its clinical utility in diagnosis of cardiovascular disease, determination of therapeutic strategy, assessment of effects of therapy and prediction of prognosis.