Myocardial contrast echocardiography (MCE) can be of prognostic value in patients presenting to hospital with acute chest pain and negative troponin, according to UK researchers. Myocardial contrast echocardiography (MCE) can be of prognostic value in patients presenting to hospital with acute chest pain and negative troponin, according to UK researchers.

"MCE, which is a bedside technique, can be used in the emergency department in patients with suspected heart attack where results by conventional methods are unclear," Dr. Roxy Senior told Reuters Health. "The study demonstrated that MCE can rule in or rule out coronary heart disease."

Dr. Senior of Northwick Park Hospital, Harrow, and colleagues studied the utility of the approach in 158 patients with suspected acute coronary syndrome. All had non-diagnostic electrocardiograms and negative troponin findings, according to the team's report in the May 15th issue of the American Journal of Cardiology.

TIMI scores were determined, and low-power MCE at rest and during vasodilator stress was performed.

After a mean follow-up of eight months, the team found that the 27 patients with abnormal MCE results were significantly more likely to experience cardiac death, myocardial infarction and revascularization than were the other patients (59 versus seven per cent). Few patients (three per cent) with normal MCE results died or had non-fatal MI.

Furthermore, the researchers found that the cardiac event rate in patients with MCE abnormalities was significantly higher (59 per cent) than among those classified as high risk based on TIMI scores (33 per cent).

"Thus," continued Dr. Senior, "if MCE is normal, patients may be discharged and if it is abnormal the patient will be admitted and managed for coronary heart disease and may also undergo coronary arteriography."

Therefore, "MCE may be a cost-effective method of managing patients with suspected acute coronary syndrome presenting to the emergency department.