Contrast-Enhanced Ultrasound for Myocardial Perfusion Imaging

Bulte, Carolien S. E.; Slikkerveer, Jeroen; Meijer, Rick I.; Gort, Dennis; Kamp, Otto; Loer, Stephan A.; Marchi, Stefano F. de; Vogel, Rolf; Boer, Christa; Bouwman, R. Arthur

doi:10.1213/ane.0b013e318248e261

Cited by 19 publications

(16 citation statements)

References 27 publications

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“…In contrast to prior studies where MP was estimated over a subjectively selected region of interest using CEUS, our study used a custom-designed algorithm, which provided high-resolution MP estimation based on plateau image intensity data (18)(19)(20)(21)(22)(23). The high-resolution, pixel-by-pixel parametric perfusion maps indicated subtle, regional dysfunction in graft perfusion earlier than seen with histology, suggesting that the method can be used as a truly early diagnostic modality.…”

Section: Discussionmentioning

confidence: 99%

“…The transducer position was fixed using a mechanical positioning system. Nonlinear contrast imaging was performed with a smallanimal ultrasound scanner (Vevo 2100; VisualSonics, Toronto, ON, Canada) using a broadband linear transducer array (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) MHz, MS250, VisualSonics). B-mode images were used to initially locate the graft and to optimally position the transducer over the imaging plane.…”

Section: Ceus Imaging Techniquementioning

confidence: 99%

“…In addition, applying a high-intensity ultrasound pulse to burst the microbubbles in a selected field, and subsequently monitoring the time and intensity by which microbubbles are resumed in the microvasculature can yield further information regarding the microvasculature patency. One of the emerging applications of CEUS is to assess the MP of tissues (18)(19)(20)(21)(22)(23)(24). Nonetheless, the application of CEUS in the diagnosis of transplant rejection remains to be fully explored.…”

Section: Introductionmentioning

confidence: 99%

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Testing the Efficacy of Contrast-Enhanced Ultrasound in Detecting Transplant Rejection Using a Murine Model of Heart Transplantation

Fischer

Ohori

Meral

et al. 2017

American Journal of Transplantation

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One of the key unmet needs to improve long-term outcomes of heart transplantation is to develop accurate, non-invasive and practical diagnostic tools to detect transplant rejection. Early intra-graft inflammation and endothelial cell injuries occur prior to advanced transplant rejection. We developed a novel diagnostic imaging platform to detect early declines in micro-vascular perfusion (MP) of cardiac transplants using Contrast Enhanced Ultrasonography (CEUS). The efficacy of CEUS in detecting transplant rejection was tested in a murine model of heart transplants, a standard preclinical model of solid organ transplant. As compared to the syngeneic groups, a progressive decline in MP was demonstrated in the allografts undergoing acute transplant rejection (40%, 64%, 92% on days 4, 6, and 8 post-transplantation, respectively) and chronic rejection (33%, 33%, 92% on days 5, 14, and 30 post-transplantation, respectively). Our perfusion studies showed restoration of MP following anti-rejection therapy, highlighting its potential to help monitor efficacy of anti-rejection therapy. Our data suggest that early endothelial cell injury and platelet aggregation contributed to the early MP decline observed in the allografts. High-resolution MP mapping may allow for non-invasive detection of heart transplant rejection. The data presented have the potential to help in the development of next-generation imaging approaches to diagnose transplant rejection.

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Section: Discussionmentioning

confidence: 99%

Section: Ceus Imaging Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Testing the Efficacy of Contrast-Enhanced Ultrasound in Detecting Transplant Rejection Using a Murine Model of Heart Transplantation

Fischer

Ohori

Meral

et al. 2017

American Journal of Transplantation

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“…These intensities were then fitted ( Y = Y 0 + ( A − Y 0 )·(1 − exp (− β · x ) )) for calculation of microvascular blood volume A and the microvascular filling velocity β , which corresponds to the capillary blood exchange rate. The estimate of perfusion was calculated as the product of A and β [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

Myocardial Perfusion and Function Are Distinctly Altered by Sevoflurane Anesthesia in Diet-Induced Prediabetic Rats

Brom

Boly

Bulte

et al. 2016

Journal of Diabetes Research

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Preservation of myocardial perfusion during surgery is particularly important in patients with increased risk for perioperative complications, such as diabetes. Volatile anesthetics, like sevoflurane, have cardiodepressive effects and may aggravate cardiovascular complications. We investigated the effect of sevoflurane on myocardial perfusion and function in prediabetic rats. Rats were fed a western diet (WD; n = 18) or control diet (CD; n = 18) for 8 weeks and underwent (contrast) echocardiography to determine perfusion and function during baseline and sevoflurane exposure. Myocardial perfusion was estimated based on the product of microvascular filling velocity and blood volume. WD-feeding resulted in a prediabetic phenotype characterized by obesity, hyperinsulinemia, hyperlipidemia, glucose intolerance, and hyperglycemia. At baseline, WD-feeding impaired myocardial perfusion and systolic function compared to CD-feeding. Exposure of healthy rats to sevoflurane increased the microvascular filling velocity without altering myocardial perfusion but impaired systolic function. In prediabetic rats, sevoflurane did also not affect myocardial perfusion; however, it further impaired systolic function. Diet-induced prediabetes is associated with impaired myocardial perfusion and function in rats. While sevoflurane further impaired systolic function, it did not affect myocardial perfusion in prediabetic rats. Our findings suggest that sevoflurane anesthesia leads to uncoupling of myocardial perfusion and function, irrespective of the metabolic state.

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“…As previously described, transthoracic myocardial contrast echocardiography (MCE) was performed using an iE33 ultrasound scanner equipped with a S5 – 1 transducer (Philips Medical Systems, Best, The Netherlands) [18]. A contrast agent consisting of microbubbles filled with sulphur hexafluoride with a mean diameter of 2,5 μm was used (Sonovue, Bracco Imaging, Milan, Italy) and continuously infused using a specific syringe pump (VuEject, Bracco SA, Switzerland).…”

Section: Methodsmentioning

confidence: 99%

Myocardial blood flow under general anaesthesia with sevoflurane in type 2 diabetic patients: a pilot study

Bulte

Brom

Loer

et al. 2014

Cardiovasc Diabetol

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BackgroundIn type 2 diabetic patients, cardiac events in the perioperative period may be associated with diminished myocardial vasomotor function and endothelial dysfunction. The influence of sevoflurane anaesthesia on myocardial endothelial dysfunction in type 2 diabetic mellitus is investigated in this pilot study.MethodsSix males with type 2 diabetes mellitus and eight healthy controls were included. Using myocardial contrast echocardiography, myocardial blood flow (MBF) was measured at rest, during adenosine-induced hyperaemia (endothelium-independent vasodilation) and after sympathetic stimulation by the cold pressor test (endothelium-dependent vasodilation). Measurements were performed before and after induction of sevoflurane anaesthesia.ResultsSevoflurane anaesthesia decreased resting MBF in diabetics but not in controls (P = 0.03), while baseline MBF did not differ between diabetics and controls. Without anaesthesia, adenosine-induced hyperaemia increased MBF in both groups compared to resting values. Adenosine combined with sevoflurane resulted in a lower hyperaemic MBF in both groups compared to no anaesthesia. Differences in MBF in response to adenosine before and after sevoflurane administration were larger in diabetic patients, however not statistically significant in this pilot group (P = 0.08). Myocardial blood flow parameters after the cold pressor test were not different between groups.ConclusionThese pilot data in type 2 diabetic patients show that sevoflurane anaesthesia decreases resting myocardial blood flow compared to healthy controls. Further, we observed a trend towards a lower endothelium-independent vasodilation capacity in diabetic patients under sevoflurane anaesthesia. Endothelium-dependent vasodilation was not affected by sevoflurane in diabetic patients. These data provide preliminary insight into myocardial responses in type 2 diabetic patients under general anaesthesia.Trial registrationhttp://www.clinicialtrials.gov, NCT00866801

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Contrast-Enhanced Ultrasound for Myocardial Perfusion Imaging

Cited by 19 publications

References 27 publications

Testing the Efficacy of Contrast-Enhanced Ultrasound in Detecting Transplant Rejection Using a Murine Model of Heart Transplantation

Testing the Efficacy of Contrast-Enhanced Ultrasound in Detecting Transplant Rejection Using a Murine Model of Heart Transplantation

Myocardial Perfusion and Function Are Distinctly Altered by Sevoflurane Anesthesia in Diet-Induced Prediabetic Rats

Myocardial blood flow under general anaesthesia with sevoflurane in type 2 diabetic patients: a pilot study

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