ECHOCARDIOGRAPHIC ASSESSMENT OF MYOCARDIAL PERFUSION

    Project: Research project

    Project Details

    Description

    The current methods of quantitating regional myocardial perfusion in humans
    are limited. Myocardial contrast echocardiography (MCE) is a developing
    technique that utilizes state-of-the-art ultrasound technology coupled with
    the injection of precision microbubbles of air into the circulation. As
    these bubbles traverse the myocardium, they produce contrast enhancement on
    echocardiography which can be quantitated. The aim of the current research
    program is to quantitate regional myocardial blood flow in the beating
    heart using MCE and to derive pathophysiologic insight from this
    information into acute and chronic ischemic syndromes in humans. The specific aims of this research program in relation to MCE are: a)
    Quantitation of myocardial blood flow in-vivo in the beating canine and
    human heart; b) Transpulmonary opacification of the myocardium from a
    venous injection of contrast and studying its role during coronary
    occlusion and reperfusion; c) Assessment of myocardial viability in
    patients with acute myocardial infarction and those with 'hibernating
    myocardium' (multi-vessel disease and reduced left ventricular function)
    and comparing this information to that obtained on thallium-201 imaging; d)
    Risk-stratification of patients undergoing major vascular surgery based on
    their myocardial perfusion patterns during venous injection of contrast and
    comparing this information to that obtained on thallium-201 imaging; and,
    e) Assessment of coronary blood flow reserve in both dogs and humans from
    intra-aortic injection of contrast (in humans, prior to and following
    coronary angioplasty). The ultimate goal of this proposal is the
    quantitation of regional myocardial flow-function relations in humans using
    MCE in order to better understand pathophysiology in various ischemic
    syndromes. In order to better control the experimental conditions, studies will first
    be performed in canine models prior to deriving information from patients.
    Validation of microbubble transit rates will be performed with radiolabeled
    red cells and regional myocardial blood flow with radiolabeled
    microspheres. Infarct size will be measured using vital stains and risk
    area will be assessed using technetium autoradiography. Quantitative MCE
    will be performed using image analysis techniques and mathematical modeling
    based on indicator-dilution principles. In patients, perfusion will be
    compared against thallium-201 images and parameters of blood flow reserve
    will be compared with intravascular ultrasound images and quantitative
    coronary angiography.
    StatusFinished
    Effective start/end date8/1/925/31/05

    Funding

    • National Institutes of Health
    • National Institutes of Health
    • National Institutes of Health
    • National Institutes of Health
    • National Institutes of Health: $301,623.00
    • National Institutes of Health
    • National Institutes of Health: $366,160.00
    • National Institutes of Health: $357,854.00
    • National Institutes of Health
    • National Institutes of Health: $213,722.00
    • National Institutes of Health: $202,683.00

    ASJC

    • Medicine(all)

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