Potential clinical applications of myocardial contrast echocardiography in evaluating myocardial perfusion in coronary artery disease

Aggeli, Constadina; Bonou, Μaria; Stefanadis, Christodoulos

doi:10.1016/j.ijcard.2004.11.010

Cited by 5 publications

(4 citation statements)

References 59 publications

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“…By combining wall motion and myocardial perfusion images, stress MCE significantly improved the diagnostic value and diagnostic accuracy for CHD. Furthermore, it is able to more accurately identify surviving and dead myocardium and detect myocardial reserve function ( 12-14 ).…”

Section: Discussionmentioning

confidence: 99%

Low‑dose dobutamine stress myocardial contrast echocardiography for the evaluation of myocardial microcirculation and prediction of overall cardiac function recovery

et al. 2020

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The study aimed to investigate the role of low-dose dobutamine stress myocardial contrast echocardiography (MCE) in evaluating myocardial local microcirculation and predicting cardiac function recovery in patients with myocardial infarction. A total of 50 patients with acute myocardial infarction (AMI) were enrolled in the present study. Positron emission tomography was used as a gold standard to determine viable/non-viable myocardial segments in infarcted myocardial region. MCE and dobutamine stress MCE were carried out 72 h after PCI. MCE was carried out again to evaluate myocardial condition at 6 months after PCI. As compared with normal myocardial segments, resting MCE revealed a significant decrease of the values of A (the peak intensity of the time-perfusion intensity curve, reflecting the myocardial blood volume), β (the slope of the curve, reflecting the myocardial blood flow (MBF) velocity) and A x β (reflecting MBF) of viable and non-viable myocardial segments. After being challenged by dobutamine, the values of A, β and A x β of normal coronary blood supply areas were significantly increased; while the segments A and A x β of viable myocardium were markedly decreased. Patients were further divided into two groups based on the changes in the contrast-enhanced index (CSI) following dobutamine loading. In the dobutamine stress echocardiography-positive group (the CSI increased or decreased by >0.2), the left ventricular ejection fraction was significantly increased and pro-B-type natriuretic peptide significantly decreased at 6 months following intervention. Low-dose dobutamine stress MCE was indicated to be an effective method to evaluate myocardial microcirculation perfusion in patients with AMI following PCI. In addition, CSI, as a simple semi-quantitative index, may predict left ventricular function in patients with AMI.

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Section: Discussionmentioning

confidence: 99%

Low‑dose dobutamine stress myocardial contrast echocardiography for the evaluation of myocardial microcirculation and prediction of overall cardiac function recovery

et al. 2020

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“…Regions of interest are drawn and time intensity curves are fitted to a mono-exponential function, where A is plateau intensity reflecting the myocardial blood volume, which is strongly correlated with microvessel density on histochemical staining slice of human myocardial biopsy tissue, and the exponential k is the mean refilling velocity of myocardial microbubbles with intravascular kinetics comparable to that of red blood cells, and reflects myocardial blood velocity. Consequently, the product of A and k provides an objective estimate of myocardial blood flow [2,24] .…”

Section: Discussionmentioning

confidence: 99%

“…Coronary angiography can show the state of epicardial blood flow, but doesn't provide accurate information of myocardial perfusion in the coronary microcirculation [1] . Real-time myocardial contrast echocardiography (RT-MCE) is an emerging technique in which microbubble contrast agents are visualized in the coronary microcirculation [2][3][4][5][6][7] . Several studies have recently demonstrated that the recovery of left ventricular function related the level of myocardia l perfusion [8][9][10] .…”

mentioning

confidence: 99%

Assessment of myocardial perfusion and systolic function in patients with coronary artery disease after coronary artery bypass surgery by myocardial contrast echocardiography and two-dimensional strain echocardiography

Liu

Deng

et al. 2009

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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The clinically applied value of myocardial perfusion and systolic function in patients with coronary artery disease after coronary artery bypass surgery using real-time myocardial contrast echocardiography (RT-MCE) combined with two-dimensional strain echocardiography was assessed. Twenty patients underwent intravenous RT-MCE by intravenous injections of SonoVue before and after coronary artery bypass surgery. Two-dimensional images were recorded from the left ventricular four-chamber view, two-chamber view and the apical view before, and two weeks and three months after coronary artery bypass surgery, and the peak systolic longitudinal strain was measured. The results showed that myocardial perfusion was significantly increased after coronary artery bypass surgery in about 71.6% segments. In the group that myocardial perfusion was improved, the peak systolic longitudinal strain three months after bypass surgery was significantly higher than that before operation [(-15.78+/-5.91)% vs (-10.45+/-8.31)%, P<0.05]. However, the parameters did not change in the group without myocardial perfusion improvement [(-10.33+/-6.53)% vs (-9.41+/-6.09)%, P>0.05]. It was concluded that whether or not the improvement of myocardial perfusion can mirror the recovery trend of regional systolic function, two-dimensional strain echocardiography can observe dynamic change of regional systolic function. The combination of myocardial perfusion with two-dimensional strain echocardiography can more accurately assess the curative effectiveness of coronary artery bypass surgery.

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“…Their clinical efficacy has been proven by various researchers that have extensively tested the implementation of contrast in a variety of applications [1][2][3]. As a result their use has been endorsed by the American and European societies of echocardiography, who have issued guidelines regarding contrast indications [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Contrast Agents: Updated Data on Safety Profile

Aggeli

Felekos²,

Siasos³

et al. 2012

CPD

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Contrast echocardiography represents a major technological advancement in the constantly evolving field of cardiovascular imaging. Over the last twenty years numerous studies have been published, illustrating the incremental value of contrast implementation into a variety of clinical scenarios. However, serious concerns have been raised about contrast safety profile, mainly based on postmarketing observational data and several animal studies. The latter have investigated contrast bio effects under experimental conditions that are not consistent with daily clinical practice. On the other hand, numerous clinical trials with large registries have proven otherwise. Not only contrast agents are efficient, but they also demonstrate a remarkable safety profile. So the question is: should we fear contrast utilization or should we consider them as an adjunctive and indispensable clinical tool for daily bedside practice?

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Potential clinical applications of myocardial contrast echocardiography in evaluating myocardial perfusion in coronary artery disease

Cited by 5 publications

References 59 publications

Low‑dose dobutamine stress myocardial contrast echocardiography for the evaluation of myocardial microcirculation and prediction of overall cardiac function recovery

Low‑dose dobutamine stress myocardial contrast echocardiography for the evaluation of myocardial microcirculation and prediction of overall cardiac function recovery

Assessment of myocardial perfusion and systolic function in patients with coronary artery disease after coronary artery bypass surgery by myocardial contrast echocardiography and two-dimensional strain echocardiography

Ultrasound Contrast Agents: Updated Data on Safety Profile

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