Circulation, Vol 74, 389-400, Copyright © 1986 by American Heart Association
SA Wickline, LJ Thomas 3d, JG Miller, BE Sobel and JE Perez
We have shown recently that tissue characterization of myocardium with
ultrasound reflects changes associated with contractile function throughout
the cardiac cycle. To determine whether ultrasonic tissue characterization
can sensitively detect the impact of ischemic injury and reperfusion on
contractile properties of the heart, we studied the time course of change
of backscatter after 5, 20, and 60 min of coronary occlusion followed by
reperfusion in 15 dogs. The time- averaged integrated backscatter (IB) and
the amplitude and phase of cyclic variation of IB (phase relative to the
left ventricular pressure waveform) were measured. A novel ultrasonic index
of acute injury was identified, the phase-weighted amplitude of cyclic
variation, and calculated by weighting the amplitude of cyclic variation of
IB with respect to the phase. We hypothesized that backscatter variables
would change dramatically after occlusion and that their restitution after
reperfusion would sensitively reflect the extent and time course of
reversibility of ischemic injury. After coronary occlusion, segmental wall
thickening decreased from approximately 55% to 5% regardless of the
duration of ischemia. Changes in backscatter associated with this decrease
included an increase in time-averaged IB of approximately 5 dB, a 5 dB
decrease in cyclic variation, an 80 degree phase shift, and a 7 dB decrease
in phase-weighted amplitude. Wall thickening after reperfusion immediately
after the 5, 20, or 60 min occlusions recovered to 45%, 27%, and 12% of
baseline values, respectively. Within 3 hr it recovered to 53%, 44%, and
22%. Time-averaged IB recovered initially by 89%, 61%, and 44% (all p less
than .05) and continued to recover subsequently although more slowly.
Ultimate recovery was virtually complete. In contrast to the rapid recovery
of time-averaged IB, phase- weighted amplitude recovered initially to only
72%, 41%, and -7% of baseline (all p less than .05) and manifested slower
and incomplete recovery when ischemia had been present for 20 or 60 min.
After reperfusion, the time course of both cyclic variation and phase were
reflected by changes in the phase-weighted amplitude. The backscatter
variables assessed appear to sensitively delineate the duration, time
course of recovery, and reversibility of ischemic injury in response to
reperfusion. The results suggest that early recovery of time-averaged IB
corresponds in part to the restoration of tissue ultrastructural
integrity.(ABSTRACT TRUNCATED AT 400 WORDS)
ARTICLES
Sensitive detection of the effects of reperfusion on myocardium by ultrasonic tissue characterization with integrated backscatter
This article has been cited by other articles:
 |
|
 |
|
  E Hyodo, T Hozumi, Y Takemoto, H Watanabe, T Muro, H Yamagishi, M Yoshiyama, K Takeuchi, and J Yoshikawa Early detection of cardiac involvement in patients with sarcoidosis by a non-invasive method with ultrasonic tissue characterisation Heart, November 1, 2004; 90(11): 1275 - 1280. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Iwakura, H. Ito, S. Kawano, A. Okamura, K. Asano, T. Kuroda, K. Tanaka, T. Masuyama, M. Hori, and K. Fujii Detection of TIMI-3 Flow Before Mechanical Reperfusion With Ultrasonic Tissue Characterization in Patients With Anterior Wall Acute Myocardial Infarction Circulation, July 1, 2003; 107(25): 3159 - 3164. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. Hancock, J. C. Cooke, D. T. Chin, and M. J. Monaghan Determination of Successful Reperfusion After Thrombolysis for Acute Myocardial Infarction: A Noninvasive Method Using Ultrasonic Tissue Characterization That Can Be Applied Clinically Circulation, January 15, 2002; 105(2): 157 - 161. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T Muro, T Ota, H Watanabe, M Teragaki, K Takeuchi, and J Yoshikawa Prediction of contractile reserve by cyclic variation of integrated backscatter of the myocardium in patients with chronic left ventricular dysfunction Heart, February 1, 2001; 85(2): 165 - 170. [Abstract] [Full Text]
|
|
|
|
 |
|
 K. Imasaka, S. Morita, I. Nagano, M. Masuda, R. Tominaga, and H. Yasui Coronary artery bypass grafting on the beating heart evaluated with integrated backscatter Ann. Thorac. Surg., September 1, 2000; 70(3): 1049 - 1053. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Colonna, R. Montisci, L. Galiuto, L. Meloni, and S. Iliceto Effects of acute ischaemia on intramyocardial contraction heterogeneity; new ultrasound technologies to study an old phenomenon Eur. Heart J., March 1, 1999; 20(5): 327 - 337. [PDF]
|
|
|
|
|
|
S. Takiuchi, H. Ito, K. Iwakura, Y. Taniyama, N. Nishikawa, T. Masuyama, M. Hori, Y. Higashino, K. Fujii, and T. Minamino Ultrasonic Tissue Characterization Predicts Myocardial Viability in Early Stage of Reperfused Acute Myocardial Infarction Circulation, February 3, 1998; 97(4): 356 - 362. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. F. Vitale, R. O. Bonow, R. Calabro, M. De Cristofaro, G. Pacileo, P. Caso, G. Gerundo, C. Bordini, M. A. Losi, C. Rengo, et al. Myocardial Ultrasonic Tissue Characterization in Pediatric and Adult Patients With Hypertrophic Cardiomyopathy Circulation, December 1, 1996; 94(11): 2826 - 2830. [Abstract] [Full Text]
|
|
|
|
|
|
S. Nozaki, A. N. DeMaria, G. A. Helmer, and H. K. Hammond Detection of Regional Left Ventricular Dysfunction in Early Pacing-Induced Heart Failure Using Ultrasonic Integrated Backscatter Circulation, November 1, 1995; 92(9): 2676 - 2682. [Abstract] [Full Text]
|
|
|
|
|
|
D. F. Vitale, R. O. Bonow, G. Gerundo, N. Pelaggi, G. Lauria, D. Leosco, F. Coltorti, C. Bordini, C. Rengo, and F. Rengo Alterations in Ultrasonic Backscatter During Exercise-Induced Myocardial Ischemia in Humans Circulation, September 15, 1995; 92(6): 1452 - 1457. [Abstract] [Full Text]
|
|
|
|
|
|
W. D. O'Brien Jr, K. B. Sagar, D. C. Warltier, and T. L. Rhyne Acoustic Propagation Properties of Normal, Stunned, and Infarcted Myocardium : Morphological and Biochemical Determinants Circulation, January 1, 1995; 91(1): 154 - 160. [Abstract] [Full Text]
|
|
|
|
 |
|
 A. D. Waggoner, B. Barzilai, J. G. Miller, and J. E. Perez Quantitative Echocardiography, Part 1: Myocardial Tissue Characterization with Analysis of Radiofrequency Signas Journal of Diagnostic Medical Sonography, May 1, 1993; 9(3): 122 - 134. [Abstract] [PDF]
|
|