TY - JOUR
T1 - Quantification of myocardial perfusion and determination of coronary stenosis severity during hyperemia using real-time myocardial contrast echocardiography
AU - Leong-Poi, Howard
AU - Le, Elizabeth
AU - Rim, Se Joong
AU - Sakuma, Tadamichi
AU - Kaul, Sanjiv
AU - Wei, Kevin
N1 - Funding Information:
Supported in part by grants from the National Institutes of Health (RO1-HL-48890 and K08-HL-03909, Bethesda, Md), the Mid-Atlantic Affiliate of the American Heart Association (B98458V, Baltimore, Md), and the Fourjay Foundation (Williamsport, Pa). Mallinckrodt Medical, Inc (St Louis, Mo) provided the contrast agent, Dupont Medical Products (North Billerica, Mass) provided the radiolabeled microspheres, and the ultrasound equipment was provided by Advanced Technology Laboratories (Bothell, Wash). Dr Leong-Poi is the recipient of a Fellowship training grant from the Canadian Institute of Health Research and the Heart and Stroke Foundation of Canada (Ottawa, Canada), and Dr Le was the recipient of a postdoctoral training grant (HL-07355) from the National Institutes of Health.
PY - 2001
Y1 - 2001
N2 - Although regional myocardial perfusion can be currently quantified with myocardial contrast echocardiography (MCE) by using intermittent harmonic imaging (IHI), the method is tedious and time-consuming in the clinical setting. We hypothesized that regional myocardial perfusion can be quantified and the severity of coronary stenosis determined during hyperemia with MCE using real-time imaging (RTI) where microbubbles are not destroyed. Six open-chest dogs were studied during maximal hyperemia induced by adenosine in the absence or presence of coronary stenoses varying from mild to severe. Myocardial blood flow (MBF) was measured at each stage by using radiolabeled microspheres. MCE was performed using both IHI and RTI. Data for the latter were acquired in both end-systole and enddiastole. No differences were found between myocardial flow velocity (MFV) derived from IHI and RTI when end-systolic frames were used for the latter. MFV was consistently higher for RTI (P < .01) when end-diastolic frames were used. A linear relation was noted between MFV and radiolabeled microsphere-derived MBF ratios from the stenosed and the normal beds when end-systolic frames were used for RTI (r = 0.78, P < .001), whereas no relation was found when end-diastolic frames were used (r = 0.08, P = .78). The scatter for assessing MBF (A·β) was minimal for IHI and RTI (9%-10%) with end-systolic frames, whereas that for RTI with end-diastolic frames was large (30%). Furthermore the correlation with radiolabeled microsphere-derived MBF was significantly (P < .01) weaker with RTI when end-diastolic frames were used (r = 0.53) than when end-systolic frames (r = 0.94) or IHI was used (r = 0.99). Data acquisition for IHI was 10 minutes, whereas it was 8 seconds for RTI. Thus, RTI can be used to quantify regional myocardial perfusion and stenosis severity during MCE. Only end-systolic frames, however, provide accurate data. RTI offers a rapid and easy means of assessing regional myocardial perfusion with MCE.
AB - Although regional myocardial perfusion can be currently quantified with myocardial contrast echocardiography (MCE) by using intermittent harmonic imaging (IHI), the method is tedious and time-consuming in the clinical setting. We hypothesized that regional myocardial perfusion can be quantified and the severity of coronary stenosis determined during hyperemia with MCE using real-time imaging (RTI) where microbubbles are not destroyed. Six open-chest dogs were studied during maximal hyperemia induced by adenosine in the absence or presence of coronary stenoses varying from mild to severe. Myocardial blood flow (MBF) was measured at each stage by using radiolabeled microspheres. MCE was performed using both IHI and RTI. Data for the latter were acquired in both end-systole and enddiastole. No differences were found between myocardial flow velocity (MFV) derived from IHI and RTI when end-systolic frames were used for the latter. MFV was consistently higher for RTI (P < .01) when end-diastolic frames were used. A linear relation was noted between MFV and radiolabeled microsphere-derived MBF ratios from the stenosed and the normal beds when end-systolic frames were used for RTI (r = 0.78, P < .001), whereas no relation was found when end-diastolic frames were used (r = 0.08, P = .78). The scatter for assessing MBF (A·β) was minimal for IHI and RTI (9%-10%) with end-systolic frames, whereas that for RTI with end-diastolic frames was large (30%). Furthermore the correlation with radiolabeled microsphere-derived MBF was significantly (P < .01) weaker with RTI when end-diastolic frames were used (r = 0.53) than when end-systolic frames (r = 0.94) or IHI was used (r = 0.99). Data acquisition for IHI was 10 minutes, whereas it was 8 seconds for RTI. Thus, RTI can be used to quantify regional myocardial perfusion and stenosis severity during MCE. Only end-systolic frames, however, provide accurate data. RTI offers a rapid and easy means of assessing regional myocardial perfusion with MCE.
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U2 - 10.1067/mje.2001.115982
DO - 10.1067/mje.2001.115982
M3 - Article
C2 - 11734784
AN - SCOPUS:0035205826
SN - 0894-7317
VL - 14
SP - 1173
EP - 1182
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 12
ER -