(Circulation. 1997;96:3745-3760.)
© 1997 American Heart Association, Inc.
Articles |
Myocardial Contrast Echocardiography
15 Years of Research and Development
From the Cardiovascular Division, University of Virginia School of Medicine, Charlottesville, Va.
Correspondence to Sanjiv Kaul, MD, Cardiovascular Division, Box 158, Medical Center, University of Virginia, Charlottesville, VA 22908. E-mail sk@virginia.edu
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Introduction |
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"An untroubled mind, no longer seeking to consider what is right and what is wrong; A mind beyond judgements, watches and understands."
The Buddha (translated from the Dhammapada)
The purpose of this article is to describe our personal experience in translating observations made in the experimental laboratory using MCE into the clinical setting. It is not intended to be an exhaustive review of MCE, for which readers are referred elsewhere.1 2 3 The work of others in MCE and related subjects will be mentioned only when it has influenced our own work. Our bench-to-bedside experience with MCE over the past 15 years will be discussed under these six broad categories: (a) technical issues; (b) AMI, (c) detection of CAD, (d) applications in the operating room, (e) quantification of myocardial perfusion, and (f) work in progress.
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Technical Issues |
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Historically, it has not been possible to directly assess myocardial perfusion with echocardiography. Its clinical focus has involved the evaluation of cardiac chamber size and function, valve morphology and kinetics, pericardial space and great vessels, and intracavitary blood flow velocities. Yet, echocardiography is highly suited for the evaluation of myocardial perfusion for the following reasons: (a) It has very good spatial resolution (<1 mm in the axial direction), which is far superior to that offered by SPECT and positron emission tomography, although not as good as magnetic resonance imaging and ultrafast cine computed tomography; (b) its temporal resolution is excellent (30 to 120 Hz) and exceeds that of other commonly used imaging technologies; (c) for an
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