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Quantitative assessment of myocardial perfusion during graded coronary stenosis by real-time myocardial contrast echo refilling curves.

Abstract：

OBJECTIVES:The present study examined the ability of real-time myocardial contrast echocardiography (MCE) to delineate abnormalities produced by graded coronary stenoses and to correlate signal intensity (SI) parameters derived from destruction/refilling curves with regional myocardial blood flow (MBF) and contractile function. BACKGROUND:Recent technological advances have enabled myocardial opacification by MCE to be achieved during real-time imaging. METHODS:In eight open-chest dogs, we created LAD occlusion and graded stenoses that were either flow-limiting at rest (FLS) or reduced adenosine hyperemia (non-flow-limiting at rest = NFLS). Myocardial contrast echo used Optison infusion and low-energy real-time power pulse inversion imaging. High-energy FLASH frames destroyed bubbles every 15 cardiac cycles. Myocardial SI-versus-time plots were fitted to a one-exponential function to obtain the rate of SI rise (b) and peak SI in the last frame. RESULTS:Dyssynergy was not observed during any NFLS, but perfusion abnormalities were. Visual detection of decreased opacification was possible with severe NFLS and FLS. b demonstrated a significant reduction with severe NFLS and near significant with moderate NFLS; peak SI did not. All exponential parameters were significantly decreased with FL stenosis and occlusion. The MBF ratio in LAD/LCx beds (fluorescent microspheres) correlated with b (r = 0.79) and the product of the peak SI and b (r = 0.80). CONCLUSIONS:In an open-chest dog model, parameters derived from microbubble refilling of the imaging field by real-time MCE correlate well with myocardial blood flow and can identify coronary stenosis.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Masugata H,Peters B,Lafitte S,Strachan GM,Ohmori K,DeMaria AN

doi

10.1016/s0735-1097(00)01046-9

subject

Has Abstract

pub_date

2001-01-01 00:00:00

pages

262-9

issue

1

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(00)01046-9

journal_volume

37

pub_type

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