RecruitingNot ApplicableNCT07112820

Contribution of Myocardial Perfusion Imaging in the Initial Assessment of Acute Coronary Syndromes Without ST Elevation for the Diagnosis of Myocardial Infarction or Differential Diagnoses

Sponsor

Fondation Hôpital Saint-Joseph

Enrollment

100 participants

Start Date

Jun 24, 2024

Study Type

INTERVENTIONAL

Conditions

Myocardial Infarction (MI)

Summary

Patients with myocardial infarction require invasive treatment involving coronary angiography to confirm the diagnosis and, in most cases, treatment by angioplasty/stenting. Trans-thoracic ultrasound is central to the initial management of patients admitted to hospital with acute coronary syndrome without ST segment elevation. The aim of our study is therefore to compare perfusion ultrasound with coronary angiography and MRI in this population in order to determine whether the performance is satisfactory.

Eligibility

Min Age: 18 Years

Inclusion Criteria8

Patient over 18 years of age
Hospitalised in cardiology as an emergency for acute coronary syndrome without ST segment elevation with indication for coronary angiography within 72 hours of admission
Not yet undergone coronary angiography.
Troponin >99th percentile, i.e. >27ng/l (troponin I, hypersensitive, Abbott)
With de novo segmental kinetic disorder on TTE or ECG repolarisation disorder outside ST elevation
Patient affiliated with a health insurance scheme
French-speaking patient
Patient who has given their free, informed and written consent

Exclusion Criteria11

Haemodynamically unstable patient: HR > 100 and/or systolic blood pressure < 90 mmHg and/or diastolic blood pressure < 60 mmHg and/or oxygen saturation < 92% in AA and/or clinical signs of hypoperfusion (mottling, cyanosis)
Rhythmically unstable patient: sustained ventricular tachycardia, sudden death recovered.
Patient with a known allergy to ultrasound contrast medium
Patient with ST segment elevation.
Patient with a contraindication to MRI.
Patient with a caricatured picture of myocarditis (fever and/or significant biological inflammatory syndrome with CRP>50mg/l)
Patients already included in a type 1 interventional research protocol (RIPH1)
Patients under guardianship or curatorship
Patients deprived of their liberty
Patients under judicial protection
Pregnant or breastfeeding patients (negative pregnancy test for women of childbearing age)

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Interventions

OTHERperfusion ultrasound

During the examination, the power of the probe will be increased in order to assess myocardial perfusion. The contrast agent bubbles are destroyed by applying a 'flash', i.e. a temporary increase in the power of the ultrasound beam. Systole after systole, on a recorded loop, the filling velocity of the myocardium, which depends on myocardial blood flow, is analysed. The assessment of perfusion is visual and qualitative.