doi: 10.1161/01.CIR.0000132613.53542.E9
(Circulation. 2004;109:3132-3135.)
© 2004 American Heart Association, Inc.
Clinician Updates |
Myocardial Contrast Echocardiography
From the Cardiovascular Imaging Center, Cardiovascular Division, University of Virginia, Charlottesville, Va.
Correspondence to Sanjiv Kaul, MD, Cardiovascular Division, Box 800158, Medical Center, University of Virginia, Charlottesville, VA 22908-0158. E-mail sk@virginia.edu
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Myocardial contrast echocardiography (MCE) is an imaging tool for the assessment of the myocardial microcirculation. It utilizes gas-filled microbubbles that are inert, remain entirely within the vascular space, and possess an intravascular rheology similar to that of red blood cells.1,2 During an intravenous infusion of these microbubbles and attainment of a steady state, the microbubbles are destroyed with high energy ultrasound and the rate of microbubble replenishment within the ultrasound beam is measured (Figure 1), which represents mean red blood cell velocity.3
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Normally, the beam fills within 5 seconds when resting flow is normal. It takes longer to fill when flow is reduced and fills faster at hyperemic flows. When the beam is fully replenished, the ultrasound signal represents relative blood volume within the beam, which translates to the volume of blood within the myocardium itself. Normalizing this value to the signal from the left ventricular cavity provides a measure of blood volume fraction.3 Therefore, unlike other experimental and clinical methods that measure myocardial blood flow (MBF), this approach provides an assessment of the 2 individual components of nutrient tissue (capillary) perfusion: Blood volume fraction and flow velocity. The product of the two is proportional to MBF. Other than the heart,3,4 this method has been used successfully and accurately for the measurement of tissue perfusion in the skeletal muscle,5 skin,6 brain,7 and kidney.8 In this update, we shall
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