TY - JOUR
T1 - Detection of coronary stenosis and myocardial viability using a single intravenous bolus injection of BR14
AU - Fisher, Nicholas G.
AU - Leong-Poi, Howard
AU - Sakuma, Tadamichi
AU - Rim, Se Joong
AU - Bin, Jian Ping
AU - Kaul, Sanjiv
N1 - Funding Information:
Supported in part by grants (3RO1-HL-48890) from the National Institutes of Health, Bethesda, Maryland, and Bracco Research SA, Geneva, Switzerland. Dupont Medical Products (Wilmington, Delaware) provided the radiolabeled microspheres and the ultrasound equipment was provided by Phillips-ATL, Bothell, Washington. Dr. Leong-Poi is the recipient of a Fellowship Training Grant from the Heart and Stroke Foundation of Canada and the Canadian Institutes of Health Research, Ottawa, Canada, and Dr. Sakuma is supported by a training grant from Yamanouchi Pharmaceuticals, Tokyo, Japan.
PY - 2002/2/6
Y1 - 2002/2/6
N2 - 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.
AB - 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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U2 - 10.1016/S0735-1097(01)01757-0
DO - 10.1016/S0735-1097(01)01757-0
M3 - Article
C2 - 11823093
AN - SCOPUS:0037028698
SN - 0735-1097
VL - 39
SP - 523
EP - 529
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 3
ER -