Document Detail

Evaluation of coronary flow reserve using myocardial contrast echocardiography in humans.
MedLine Citation:
PMID:  1597227     Owner:  NLM     Status:  MEDLINE    
To evaluate the applicability of myocardial contrast echocardiography for the assessment of coronary blood flow reserve, 21 consecutive patients undergoing coronary angiography were studied. Only patients with a single left anterior descending lesion or normal coronary angiogram were included. Intracoronary injections of sonicated albumin were performed before and after the administration of intracoronary papaverine. Good quality studies at baseline and after the administration of papaverine were obtained in 14 of 21 patients. Ten patients had a significant (greater than 75%) single left anterior descending lesion and four had normal or insignificant lesions (70% or less stenosis) in the left anterior descending coronary artery. Time-intensity curves for the left anterior descending coronary artery region of interest were generated and then the peak contrast intensity (PCI), washout half-time (T1/2) and the area under the curve (AUC) were calculated. The post-papaverine increases in PCI and in the AUC, compared to baseline, were 55 +/- 22% and 102 +/- 14% in the four patients with 70% or less left anterior descending diameter stenosis serving as a control group and 3 +/- 25% and 40 +/- 10%, respectively, in the 10 patients with significant left anterior descending coronary artery disease (mean +/- 1 SD, P less than 0.01). In patients with normal coronary arteriography T1/2 increased after intracoronary injection of papaverine. In patients with severe lesions, either an increase or a decrease in T1/2 was observed. Significant left anterior descending coronary artery stenosis associated with impaired coronary blood flow reserve can be detected by failure of myocardial contrast echocardiographic parameters to increase after injection of papaverine. Mild and transient side effects were noted in three patients.
S A Reisner; L S Ong; P G Fitzpatrick; G S Lichtenberg; J T Sullebarger; M N Allen; R S Meltzer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  European heart journal     Volume:  13     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-07-07     Completed Date:  1992-07-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  389-94     Citation Subset:  IM    
Department of Medicine, University of Rochester, NY.
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MeSH Terms
Albumins / diagnostic use
Contrast Media
Coronary Angiography
Coronary Circulation* / drug effects
Coronary Disease / physiopathology,  radiography,  ultrasonography*
Echocardiography* / methods
Evaluation Studies as Topic
Middle Aged
Papaverine / adverse effects,  diagnostic use,  pharmacology
Reg. No./Substance:
0/Albumins; 0/Contrast Media; 58-74-2/Papaverine

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