Contrast echocardiography during coronary arteriography in humans: Perfusion and anatomic studies

Abstract

In humans, the physiologic relation between myocardial blood flow and epicardial coronary artery anatomy remains poorly defined. With the recent development of sonicated microbubble contrast agents, it is now possible to use contrast echocardiography to assess myocardial perfusion and to correlate blood flow with angiographically identified coronary artery anatomy. The purpose of the current study was to determine myocardial perfusion patterns in patients without significant coronary artery disease. The results may be used as a reference to analyze myocardial blood flow in patients with coronary artery disease. Sonicated meglumine sodium diatrizoate solution (Renografin-76), which contains microbubbles measuring 4.5 +/- 2.8 micrograms in diameter by laser analysis, was used as the echocardiographic contrast agent during elective coronary arterriography in 14 patients without significant coronary artery disease. Patients received intracoronary injections of 1.5 to 2 ml of sonicated Renografin-76 without complications. Perfusion characteristics were studied by visual assessment of the two-dimensional echocardiographic images obtained after individual injections. In patients found to be free of significant coronary artery disease by arteriography, the left coronary system always supplied the anteroseptal, anterior, anterolateral and posterior regions of the left ventricle at the mid-papillary, cross-sectional level. The right coronary artery system perfused the inferior and inferoseptal regions in 89% of the patients identified with a right dominant system. The anterolateral papillary muscle was perfused from the left coronary system in all cases. The posteromedial papillary muscle was perfused from the left coronary system in 58% of the patients and from the right system in 42% of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Echocontrast enhancers — how safe are they?

“…The microbubbles measured 3.8 ± 2.1 f.Lm and no complications were reported. In a further study in 14 patients, Feinstein et al [41] used MC-2DE with sonicated "Renograffin-76" (bubble size 4.5 ± 2.8 f.lm) to determine myocardial perfusion patterns in patients without significant coronary artery disease. No major complications were again reported although there were transient changes in heart rate, blood pressure and ECG during the intracoronary injections.…”

A super‐resolution ultrasound method for brain vascular mapping

“…Micrometer-size gas bubbles are exceptional scatters of ultrasound and have been used as intravascular contrast agents for over two decades. 19,20 With our hemispherical array, and using passive beamforming, we can optimize the imaging resolution for a given frequency and achieve sufficient SNR to image single bubbles through a human skullcap. Here we transcranially excite single microbubbles flowing through a tube phantom and generate threedimensional maps of the bubbles, using a bubble-based phase correction technique, similar to those proposed by others for phase correction of the transmit beam, 21,22 but modified to apply to the receive case.…”

Efficacy and Adverse Effects of Transpulmonary Contrast Echocardiography Using Sonicated Albumin.

“…Left heart contrast echocardiography has been performed by injecting contrast agents directly into the aortic root (1,2), the left ventricle (3,4) or the coronary artery (2,(5)(6)(7)(8). Although this technique has been helpful to identify abnormal cardiac structure (1 , 3), determine valvular regurgitation (4), demonstrate left-to-right shunts (4,9) and evaluate myocardial perfusion (2,(5)(6)(7)(8), the insertion of arterial catheters was required.…”

“…Although this technique has been helpful to identify abnormal cardiac structure (1 , 3), determine valvular regurgitation (4), demonstrate left-to-right shunts (4,9) and evaluate myocardial perfusion (2,(5)(6)(7)(8), the insertion of arterial catheters was required. Recently, several investigators have reported left heart contrast echocardiography following intrapulmonary, right atrial or peripheral venous injection of contrast agents capable of transpulmonary passage (10)(11)(12)(13)(14)(15)(16).…”