| Detection of myocardial perfusion defects by contrast echocardiography in the setting of acute myocardial ischemia with residual antegrade flow. | |
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MedLine Citation:
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PMID: 9560746 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Although myocardial contrast echocardiography accurately demarcates area at risk during total coronary occlusion, the ability of MCE to delineate area at risk in the presence of residual antegrade flow is unknown. We hypothesized that perfusion defects in myocardial segments supplied by severe coronary stenoses with residual antegrade flow could be detected by MCE using intravenous FS069. We studied 13 open-chest dogs using an intravenous injection of FS069 during intermittent harmonic imaging. Images were collected at baseline, during acute ischemia with residual antegrade flow, physiologic hyperemia (release of stenosis), and total coronary occlusion. Regional myocardial blood flow was assessed using colored microspheres. MCE risk area during acute ischemia with residual antegrade flow and total occlusion was planimetered and compared with pathologic risk area (area unstained by monastral blue). Background-subtracted peak videointensity in the risk area was assessed for all flow states. Regional myocardial blood flow confirmed expected flow states, being significantly greater during physiologic hyperemia (4.16 +/- 1.22 ml/min/g) than at baseline (0.71 +/- 0.19 ml/min/g) and significantly diminished during coronary stenosis with residual antegrade flow (0.20 +/- 0.16 ml/min/g) and total occlusion (0.09 +/- 0.06 ml/min/g; p < 0.0001). Myocardial risk area by MCE during coronary stenosis with residual antegrade flow correlated well with pathologic risk area determined by monastral blue staining (r = 0.86). Peak videointensity during coronary stenosis (111 +/- 27) was significantly less than at baseline (157 +/- 50) but greater than during total occlusion (81 +/- 34; p < 0.0001). In conclusion, intravenous FS069 in conjunction with intermittent harmonic imaging delineates area at risk in ischemic myocardium supplied by a coronary stenoses with residual antegrade flow. The presence of a perfusion defect on MCE does not necessarily imply that the coronary artery is totally occluded. |
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Authors:
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M L Main; J F Escobar; S A Hall; A L Killam; P A Grayburn |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography Volume: 11 ISSN: 0894-7317 ISO Abbreviation: J Am Soc Echocardiogr Publication Date: 1998 Mar |
Date Detail:
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Created Date: 1998-06-05 Completed Date: 1998-06-05 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8801388 Medline TA: J Am Soc Echocardiogr Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 228-35 Citation Subset: IM |
Affiliation:
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Department of Medicine, University of Texas Southwestern Medical Center, Dallas 75235-9047, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Albumins
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diagnostic use* Animals Contrast Media* Coronary Circulation / physiology Coronary Disease / physiopathology, ultrasonography* Dogs Echocardiography* Fluorocarbons / diagnostic use* Microspheres Myocardial Ischemia / physiopathology, ultrasonography* |
| Chemical | |
Reg. No./Substance:
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0/Albumins; 0/Contrast Media; 0/FS 069; 0/Fluorocarbons |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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