Clinical Usefulness of Myocardial Contrast Echocardiography to Detect Stress-Induced Cardiomyopathy in the Emergency Department

Quantitative segmental analysis of myocardial perfusion to differentiate stress cardiomyopathy from acute myocardial infarction: A myocardial contrast echocardiography study

“…Whereas Galiuto et al used a semiquantitative method, we here analyzed MCE quantitatively using a replenishment curve and the calibrated MCI. In agreement with our present findings, Choi et al showed generally preserved perfusion status in patients with SCMP compared with AMI in an MCE study that was based on qualitative and quantitative analyses . Therefore, our current findings suggested that quantitative analyses of myocardial perfusion are needed to differentiate SCMP from AMI, as perfusion defects can often be observed, even in cases of SCMP, by qualitative assessments .…”

“…After reviewing the motion compensation when necessary, the ROI position was meticulously adjusted by each frame. The mean video intensity of each ROI was automatically calculated and plotted against time and subsequently fitted by software to the following exponential function: y = A × (1 – e –ßt ), in which A is the peak plateau contrast intensity that reflects the microvascular cross‐sectional area or myocardial blood volume, and ß represents the rate of rise in signal intensity from baseline to plateau that reflects the microbubble or myocardial blood velocity . The product of A and ß (Aß) represents the myocardial blood flow.…”

“…It has been reported that both AMI and SCMP show similar semiquantitative scores for perfusion defects on myocardial contrast echocardiography (MCE) . However, we hypothesized that a quantitative assessment of myocardial perfusion, which can quantify the severity of a myocardial perfusion defect in the dysfunctional myocardium, might help to differentiate SCMP from AMI, because AMI causes more complete damage of microvasculature resulting from the complete obstruction of the coronary artery compared with SCMP . Perfusion parameters based on a replenishment curve analysis of real‐time MCE have been established to quantify both myocardial blood volume and flow .…”

“…6 However, we hypothesized that a quantitative assessment of myocardial perfusion, which can quantify the severity of a myocardial perfusion defect in the dysfunctional myocardium, might help to differentiate SCMP from AMI, because AMI causes more complete damage of microvasculature resulting from the complete obstruction of the coronary artery compared with SCMP. 11 Perfusion parameters based on a replenishment curve analysis of real-time MCE have been established to quantify both myocardial blood volume and flow. 12,13 Additionally, calibration techniques used in the analysis of MCE, which derives relative measurements by subtracting the LV cavity contrast intensity from the myocardial contrast intensity (MCI), have been shown to overcome intersegmental differences in the MCI caused by depth-dependent attenuation of reflected sound waves.…”

Usefulness of the Parameters of Quantitative Myocardial Perfusion Contrast Echocardiography in Patients with Chronic Total Occlusion and Collateral Flow

“…Myocardial contrast echocardiography (MCE) can be used to measure the microvascularity and perfusion of the myocardium using kinetic data from myocardial contrast replenishment (MCR) curves . Microvascular obstruction as measured by MCE has been shown to be severe in patients with extended periods of ischemia.…”