Detection of coronary stenosis and myocardial viability using a single intravenous bolus injection of BR14

Nicholas G. Fisher, Howard Leong-Poi, Tadamichi Sakuma, Se Joong Rim, Jian Ping Bin, Sanjiv Kaul

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVES: The aim of the study was to determine whether coronary stenosis can be detected and myocardial viability assessed after myocardial infarction from a single venous bolus injection of BR14, a new ultrasound contrast agent. BACKGROUND: BR14 is an ultrasound contrast agent that, like 201Tl, demonstrates redistribution. Whether this principle can be used to determine myocardial viability is not known. METHODS: Non-critical (n = 6) or flow-limiting (n = 4) stenoses were placed on coronary arteries of 10 open-chest dogs, which then underwent 2 h of coronary occlusion followed by reperfusion through the stenosis. Hyperemia was induced to create flow mismatch in the dogs with non-critical stenosis. Hyperemia was not induced in dogs with reduced resting coronary blood flow. All dogs were given 2 ml of BR14 as a bolus injection and serial images were obtained. Myocardial blood flow (MBF) was measured using radiolabeled microspheres. At the end of the experiment, tissue staining was performed to determine infarct size and topography. RESULTS: Initial images demonstrated flow mismatch between the normal bed and that subtended by the stenosis (during hyperemia in dogs without critical stenosis and during rest in those with reduced resting MBF). The perfusion defect size correlated well with radiolabeled microsphere-derived hypoperfused zone (r = 0.89). Regions within the hypoperfused zone that had not undergone necrosis showed redistribution, whereas the necrotic regions showed a persistent defect, the size of which correlated well with infarct size (r = 0.80). CONCLUSIONS: Because of its ability to redistribute, BR14 can define regions of relative hypoperfusion and also discriminate between infarcted and viable tissue within the hypoperfused zone after a single venous injection. This property lends itself to assessing myocardial perfusion during exercise stress.

Original languageEnglish (US)
Pages (from-to)523-529
Number of pages7
JournalJournal of the American College of Cardiology
Volume39
Issue number3
DOIs
StatePublished - Feb 6 2002
Externally publishedYes

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Coronary Stenosis
Intravenous Injections
Pathologic Constriction
Dogs
Hyperemia
Microspheres
Contrast Media
Injections
Perfusion
Coronary Occlusion
Reperfusion
Coronary Vessels
Necrosis
Thorax
Myocardial Infarction
Staining and Labeling

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Detection of coronary stenosis and myocardial viability using a single intravenous bolus injection of BR14. / Fisher, Nicholas G.; Leong-Poi, Howard; Sakuma, Tadamichi; Rim, Se Joong; Bin, Jian Ping; Kaul, Sanjiv.

In: Journal of the American College of Cardiology, Vol. 39, No. 3, 06.02.2002, p. 523-529.

Research output: Contribution to journalArticle

Fisher, Nicholas G. ; Leong-Poi, Howard ; Sakuma, Tadamichi ; Rim, Se Joong ; Bin, Jian Ping ; Kaul, Sanjiv. / Detection of coronary stenosis and myocardial viability using a single intravenous bolus injection of BR14. In: Journal of the American College of Cardiology. 2002 ; Vol. 39, No. 3. pp. 523-529.
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abstract = "OBJECTIVES: The aim of the study was to determine whether coronary stenosis can be detected and myocardial viability assessed after myocardial infarction from a single venous bolus injection of BR14, a new ultrasound contrast agent. BACKGROUND: BR14 is an ultrasound contrast agent that, like 201Tl, demonstrates redistribution. Whether this principle can be used to determine myocardial viability is not known. METHODS: Non-critical (n = 6) or flow-limiting (n = 4) stenoses were placed on coronary arteries of 10 open-chest dogs, which then underwent 2 h of coronary occlusion followed by reperfusion through the stenosis. Hyperemia was induced to create flow mismatch in the dogs with non-critical stenosis. Hyperemia was not induced in dogs with reduced resting coronary blood flow. All dogs were given 2 ml of BR14 as a bolus injection and serial images were obtained. Myocardial blood flow (MBF) was measured using radiolabeled microspheres. At the end of the experiment, tissue staining was performed to determine infarct size and topography. RESULTS: Initial images demonstrated flow mismatch between the normal bed and that subtended by the stenosis (during hyperemia in dogs without critical stenosis and during rest in those with reduced resting MBF). The perfusion defect size correlated well with radiolabeled microsphere-derived hypoperfused zone (r = 0.89). Regions within the hypoperfused zone that had not undergone necrosis showed redistribution, whereas the necrotic regions showed a persistent defect, the size of which correlated well with infarct size (r = 0.80). CONCLUSIONS: Because of its ability to redistribute, BR14 can define regions of relative hypoperfusion and also discriminate between infarcted and viable tissue within the hypoperfused zone after a single venous injection. This property lends itself to assessing myocardial perfusion during exercise stress.",
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