Potential clinical implications of abnormal myocardial perfusion patterns immediately after reperfusion in a canine model: A myocardial contrast echocardiography study

Kates, Marc A.; Meza, Mario F.; Barbee, R. Wayne; Revall, Susan; Moreno, Carlos A.; Perry, Bret; Murgo, Joseph P.; Cheirif, Jorge

doi:10.1016/s0002-8703(96)90426-3

Cited by 9 publications

(3 citation statements)

References 28 publications

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“…Previous studies using direct intracoronary contrast injection have shown that failure to produce myocardial opacification by MCE nearly always indicates necrotic tissue. [1][2][3][4][5][6][7] Although dense enhancement generally indicates normal perfusion and viable myocardium, contractile performance failed to improve in Ͼ50% of the segments that manifested normal opacification after reperfusion therapy. 5,6 The results of the present study document that necrotic myocardium can be opacified by an intravenous contrast agent early after coronary reperfusion.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] From MCE produced by direct coronary injection, patterns of opacification consisting of absent, partial/patchy, 3,6 and normal uptake [1][2][3][4][5][6][7] have been observed in the reperfused zone shortly after recanalization. The absence of myocardial opacification after reperfusion has been associated with necrosis, as evidenced by a failure to recover function at follow-up.…”

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confidence: 99%

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Assessment of Myocardial Postreperfusion Viability by Intravenous Myocardial Contrast Echocardiography

et al. 2001

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Background-Although defects on intracoronary myocardial contrast echocardiography (MCE) indicate loss of viability after reperfusion, opacified segments may also exhibit persistent dyssynergy. Therefore, we related the intensity and texture of opacification produced by an intravenous contrast agent to histological findings to determine the characteristics of necrotic tissue by postreperfusion MCE. Methods and Results-MCE was performed by intravenous injection of 0.15 mL/kg QW7437 in 14 dogs who underwent 3-hour coronary occlusion followed by 3-hour reperfusion. At baseline and 3 hours after reperfusion, midventricular short-axis images were digitized and segmented. Infarction fraction (IF) for each segment was determined by triphenyltetrazolium chloride stain. Of 224 segments, 140 showed no or small infarction and served as a control group. Of 84 segments with significant infarction (IFϾ30%), 52 exhibited a defect on MCE, and 32 exhibited no defect. Echo texture was quantified by computing entropy based on the co-occurrence matrix analysis of gray-level pairs within each segment. Three hours after reperfusion, average and maximal entropies in the infarct segments without opacification defects were significantly higher than control levels. Histologically, the degree of intracapillary erythrocyte stasis was less in this group than in the infarcted segments with MCE defects with similar magnitude of tissue injuries. Conclusions-Opacification defects by MCE may be present or absent in myocardium with histologically confirmed infarction. The texture of MCE from opacified but infarcted myocardium differed significantly from control segments and may assist in determination of segmental viability after reperfusion.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Assessment of Myocardial Postreperfusion Viability by Intravenous Myocardial Contrast Echocardiography

et al. 2001

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“…Generally, failure to produce myocardial opacification by myocardial contrast echocardiography nearly always indicates necrotic tissue. [15][16][17][18][19][20][21] However, studies have shown that normal myocardial opacification does not always indicate normal perfusion or viable myocardium, [18][19][20][21] although those observations were mainly results obtained during the acute phase of infarction or in experimental occlusion-reperfusion studies. Ohmori and colleagues have shown that necrotic myocardium can be opacified by an intravenous contrast agent early after coronary reperfusion.…”

Section: Discrepancies Between Cellular Viability and Microvasculaturementioning

confidence: 99%

Assessment of myocardial perfusion abnormalities by intravenous myocardial contrast echocardiography with harmonic power Doppler imaging: comparison with positron emission tomography

Muro

Hozumi²,

Watanabe³

et al. 2003

Heart

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Background: Intravenous myocardial contrast echocardiography with harmonic power Doppler imaging (HPDI) enables assessment of myocardial perfusion. Its accuracy in comparison with positron emission tomography (PET), which is one of the most reliable clinical gold standards for myocardial perfusion, remains to be determined. Objective: To assess the ability of HPDI to identify myocardial perfusion abnormalities, using PET as a gold standard. Methods: 23 patients with myocardial infarction underwent HPDI. Images were obtained from the apical two and four chamber views at pulsing intervals of one to eight cardiac cycles with continuous infusion of Levovist (Schering, Germany). PET was done within two weeks of HPDI. The left ventricle was divided into 12 segments and myocardial opacification by HPDI and uptake of NH 3 by PET in each segment was graded as normal, mildly reduced, or severely reduced. Results: Of the 276 segments examined, adequate image quality was obtained in 226 (82%) by HPDI; 50 segments were excluded because of inadequate image quality. There were more exclusions in the basal segments than in the mid or apical segments (p < 0.0001). Of the 226 segments analysed, overall concordance between HPDI and PET was 82% (κ = 0.70). In the apex, more segments were overestimated by HPDI than were underestimated (χ 2 = 6.25, p = 0.012). Conclusions: HPDI and PET gave similar results in the assessment of myocardial perfusion abnormalities. However, poor image quality in the basal segments and overestimation of perfusion in the apical segments are current limitations of HPDI.

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Usefulness of power Doppler contrast echocardiography to identify reperfusion after acute myocardial infarction

Rocchi

Kasprzak

Galema

et al. 2001

The American Journal of Cardiology

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Potential clinical implications of abnormal myocardial perfusion patterns immediately after reperfusion in a canine model: A myocardial contrast echocardiography study

Cited by 9 publications

References 28 publications

Assessment of Myocardial Postreperfusion Viability by Intravenous Myocardial Contrast Echocardiography

Assessment of Myocardial Postreperfusion Viability by Intravenous Myocardial Contrast Echocardiography

Assessment of myocardial perfusion abnormalities by intravenous myocardial contrast echocardiography with harmonic power Doppler imaging: comparison with positron emission tomography

Usefulness of power Doppler contrast echocardiography to identify reperfusion after acute myocardial infarction

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