Document Detail


Real-time perfusion imaging with low mechanical index pulse inversion Doppler imaging.
MedLine Citation:
PMID:  11693747     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to determine how successful pulse inversion Doppler (PID) imaging would be in detecting myocardial perfusion defects during dobutamine stress echocardiography. BACKGROUND: By transmitting multiple pulses of alternating polarity (PID) at a low mechanical index, myocardial contrast enhancement from intravenously injected microbubbles can be detected using real-time frame rates. Pulse inversion Doppler imaging was performed in 117 patients during dobutamine stress echocardiography by using an intravenous bolus of a perfluorocarbon-filled, albumin-(Optison: n = 98) or liposome- (Definity: n = 19) encapsulated microbubble and a mechanical index of <0.3. The visual identification of myocardial contrast defects and wall motion abnormalities was determined by blinded review. Forty of the patients had quantitative angiography (QA) performed to correlate territorial contrast defects with stenosis diameter >50%. RESULTS: There was a virtual absence of signal from the myocardium before contrast injections in all patients. Bright myocardial opacification at peak stress was observed in at least one coronary artery territory at frame rates up to 25 Hz in 114 of the 117 patients during dobutamine stress echocardiography. Regional myocardial contrast defects at peak stress were observed in all 30 patients with >50% stenosis in at least one vessel (13 with single-vessel and 17 with multivessel disease). Contrast defects were observed in 17 territories subtended by >50% diameter stenosis that had normal wall motion at peak stress. Overall agreement between QA and myocardial contrast enhancement on a territorial basis was 83%, as compared with 72% for wall motion. CONCLUSIONS: Pulse inversion Doppler imaging allows the detection of myocardial perfusion abnormalities in real-time during stress echocardiography and will further add to the quality and sensitivity of this test.
Authors:
T R Porter; F Xie; M Silver; D Kricsfeld; E Oleary
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  37     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-11-05     Completed Date:  2001-12-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  748-53     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-1165, USA. trporter@unmc.edu
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MeSH Terms
Descriptor/Qualifier:
Albumins / diagnostic use
Contrast Media
Coronary Angiography
Coronary Circulation*
Coronary Stenosis / physiopathology*,  ultrasonography*
Echocardiography, Doppler / methods*
Echocardiography, Stress*
Female
Fluorocarbons / diagnostic use
Humans
Male
Microspheres
Middle Aged
Chemical
Reg. No./Substance:
0/Albumins; 0/Contrast Media; 0/Definity; 0/FS 069; 0/Fluorocarbons

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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