Circulation, Vol 90, 1513-1521, Copyright © 1994 by American Heart Association
DM Skyba, AR Jayaweera, NC Goodman, S Ismail, G Camarano and S Kaul
BACKGROUND: The purpose of this study was to determine whether myocardial
perfusion can be quantified with myocardial contrast echocardiography using
left atrial (LA) injection of contrast. METHODS AND RESULTS: Based on a
series of in vitro and in vivo experiments, the optimal dose of sonicated
albumin microbubbles injected into the LA for establishing a linear
relation between video intensity and blood volume in the anterior
myocardium was determined. In 10 open-chest dogs, myocardial blood flow
(MBF) was augmented by increasing myocardial blood volume (MBV) with an
intravenous infusion of phenylephrine HCl. In the presence of this drug,
left anterior descending artery stenosis was produced, followed by release
of stenosis, to change MBF within the anterior myocardium. MBV was
calculated by dividing radiolabeled microsphere-derived MBF by microbubble
transit rate. There was close coupling between MBF and MBV in the anterior
myocardium during LA injection of contrast (y = 1.0x-0.03, SEE = 1.07, r =
.92, P < .001). An excellent correlation was also noted between
background-subtracted peak video intensity and MBV (y = 0.24x + 0.73, SEE =
0.36, r = .88, P < .001). On multivariate analysis,
background-subtracted peak video intensity correlated best with MBV.
CONCLUSIONS: Myocardial perfusion can be quantified from time-intensity
curves derived from the anterior myocardium after LA injection of contrast.
Background-subtracted peak video intensity in this situation correlates
closely with MBV. When MBV and MBF are closely coupled, such as during
inotropic stimulation of the heart, background-subtracted peak video
intensity also correlates closely with MBF. Since there are similarities in
the models of LA and venous injections, these data indicate that it may be
feasible to quantify myocardial perfusion with myocardial contrast
echocardiography after venous injection of contrast.
ARTICLES
Quantification of myocardial perfusion with myocardial contrast echocardiography during left atrial injection of contrast. Implications for venous injection
Cardiovascular Division, University of Virginia School of Medicine, Charlottesville.
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