The value of real-time myocardial contrast echocardiography for detecting coronary microcirculation function in coronary artery disease patients

Sun, Lulu; Wang, Zilong; Xu, Tongda; Pan, Defeng; Liang, Li; Jiang, Hao; Wan, Xiaoping; Li, Dongye

doi:10.14744/anatoljcardiol.2017.8041

Cited by 6 publications

(7 citation statements)

References 37 publications

(35 reference statements)

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“…The A × β < 2.75 ( 20 , 21 ) is the gold standard for myocardial ischemia, with the cut-off for iFR of 0.85 for the diagnosis of coronary microcirculation. The sensitivity and specificity values for iFR-based detection of myocardial ischemia were 90.7 and 89.9%, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…RT-MCE is a reliable method for evaluating regional myocardial perfusion. It has been reported that MBF measurements obtained by intermittent and quantitative RT-MCE techniques are well correlated with Doppler blood flow measurements in animals and humans ( 20 , 21 ). In the present study, the correlation between iFR and MCE was compared from the perspective of myocardial perfusion.…”

Section: Discussionmentioning

confidence: 98%

“…The A × β < 2.75 (20,21) is the gold standard for myocardial ischemia, with the cut-off for iFR of 0.85 for the FIGURE 5 Receiver operator characteristic (ROC) curves on iFR vs. MCE (myocardial blood flow, MBF) results (P < 0.01). Diagonal segments are produced by ties.…”

Section: Instantaneous Wave-free Ratio Data At Myocardial Segment Per...mentioning

confidence: 99%

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Comparative analysis of instantaneous wave-free ratio and quantitative real-time myocardial contrast echocardiography for the assessment of myocardial perfusion

Liang

Zhu²,

Li³

et al. 2022

Front. Cardiovasc. Med.

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Background and hypothesisThe field of coronary artery physiology is developing rapidly and changing the practice of interventional cardiology. A new functional evaluation technique using the instantaneous wave-free ratio (iFR) has become an alternative to fractional flow reserve. Future research studies need to determine whether physiological indicators play a role in evaluating myocardial perfusion in the catheter room.Materials and methodsThirty-eight patients scheduled for coronary angiography and iFR evaluation underwent a real-time myocardial contrast echocardiography (RT-MCE) examination at rest. The myocardial perfusion parameters (A, β, and A × β) on the myocardial perfusion curve were quantitatively analyzed using Q-Lab software. Coronary angiography and iFR assessment were completed within 1 week after the RT-MCE examination in all patients. Correlation analysis was used to identify iFR- and MCE-related indicators. The sensitivity and specificity of iFR in the quantitative detection of coronary microcirculation were obtained.ResultsThe correlation coefficients between iFR and A, β, and A × β were 0.81, 0.66, and 0.82, respectively. The cut-off value for iFR was 0.85 for microvascular ischemia detection, while the sensitivity and specificity for the diagnosis of myocardial perfusion were 90.7 and 89.9%, respectively. The receiver operating characteristic (ROC) curve area for iFR was 0.946 in the segments related to myocardial blood flow.ConclusionThe iFR is an effective tool for detecting myocardial microcirculation perfusion, with satisfactory diagnostic performance and a demonstrated role in physiological indices used for the perfusion assessment.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

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Comparative analysis of instantaneous wave-free ratio and quantitative real-time myocardial contrast echocardiography for the assessment of myocardial perfusion

Liang

Zhu²,

Li³

et al. 2022

Front. Cardiovasc. Med.

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“…Most of our knowledge about the regulation of coronary circulation and the characteristics of coronary perfusion are based on measurements obtained from epicardial coronary artery and tissue perfusion measurements. However, the measurements obtained from the epicardial coronary artery may mask the true blood ow of myocardial vessels due to its main function [32] . The coronary artery system is composed of three parts with different functions: the proximal segment is represented by the epicardial coronary artery, which has the volume function; the middle segment is represented by the anterior artery, which has the function of maintaining the pressure at the beginning of the small artery within a narrow range; and the distal segment is represented by the intramural small artery, which has the function of matching myocardial blood supply and oxygen consumption [33] .…”

Section: Discussionmentioning

confidence: 99%

Ultrasound study of layer-specific strain and perfusion of left ventricular myocardium in patients with dilated cardiomyopathy

Tang

Guan

Mu³

2021

Preprint

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Purpose To investigate the changes in deformation and myocardial microcirculation perfusion of left ventricular three-layer myocardium in patients with dilated cardiomyopathy (DCM) by using speckle tracking imaging (STI) and myocardial contrast echocardiography (MCE). Methods Twenty-four patients with DCM and 19 healthy controls were selected. Two-dimensional and MCE dynamic images of apical four-chamber, two-chamber, and three-chamber sections and left ventricular mitral valve, papillary muscle and apex sections were collected. The peak values of longitudinal strain (LS), circumferential strain (CS), cross-sectional area of a microvessel (A) and average myocardial microvascular lesion (β) were obtained by Qlab 10.8 workstation values, and myocardial blood flow (MBF) was calculated with A × β to evaluate the deformation and coronary microvascular perfusion of left ventricular three-layer myocardium. Results The brain natriuretic peptide (BNP), left ventricular mass index (LVMI), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVEDS), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left atrial volume index (LAVI), E peak in early diastolic period/A peak velocity in late diastolic period (E/A) and average E/e' in the DCM group were higher than those in the control group (P < 0.05); left ventricular ejection fraction (LVEF), left ventricular fractional shortening (FS) rate, stroke volume (SV), cardiac output (CO), cardiac index (CI), A peak, and the e' and a' velocities of both the lateral wall and interventricular septum were smaller than those in the control group (P < 0.05). The LS, CS, A, β, and A × β of the DCM group were all lower than those of the control group, The time to peak and the cardiac cycle required to reach the peak were longer than those in the control group (P < 0.05). The pattern of myocardial strain and perfusion among myocardial layers was subendocardial > middle > subepicardial. The correlation coefficients of LS with A, β, and A × β were − 0.500, -0.279 and − 0.190, respectively, and the correlation coefficients of CS with A, β, and A × β were − 0.383, -0.255 and − 0.208, respectively. Conclusions The deformation of the three-layer myocardium and coronary microcirculation perfusion in DCM patients were diffusely damaged from the endocardium to the epicardium, layer by layer. The longitudinal function of the left ventricular myocardium was closely related to changes in myocardial microcirculation perfusion. Echocardiography is helpful to evaluate myocardial blood flow and myocardial ischemia in patients with DCM.

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Section: Discussionmentioning

confidence: 99%

Ultrasound Study of Layer-specific Strain and Perfusion of Left Ventricular Myocardium in Patients With Dilated Cardiomyopathy

Tang

Guan

2021

Preprint

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BackgroundTo investigate the changes in deformation and myocardial microcirculation perfusion of left ventricular three-layer myocardium in patients with dilated cardiomyopathy (DCM) by using speckle tracking imaging (STI) and myocardial contrast echocardiography (MCE).MethodsTwenty-four patients with DCM and 19 healthy controls were selected. Two-dimensional and MCE dynamic images of apical four-chamber, two-chamber, and three-chamber sections and left ventricular mitral valve, papillary muscle and apex sections were collected. The peak values of longitudinal strain (LS), circumferential strain (CS), cross-sectional area of a microvessel (A) and average myocardial microvascular lesion (β) were obtained by Qlab 10.8 workstation values, and myocardial blood flow (MBF) was calculated with A×β to evaluate the deformation and coronary microvascular perfusion of left ventricular three-layer myocardium.ResultsThe brain natriuretic peptide (BNP), left ventricular mass index (LVMI), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVEDS), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left atrial volume index (LAVI), E peak in early diastolic period/A peak velocity in late diastolic period (E/A) and average E/e' in the DCM group were higher than those in the control group (P < 0.05); left ventricular ejection fraction (LVEF), left ventricular fractional shortening (FS) rate, stroke volume (SV), cardiac output (CO), cardiac index (CI), A peak, and the e' and a' velocities of both the lateral wall and interventricular septum were smaller than those in the control group (P<0.05). The LS, CS, A, β, and A×β of the DCM group were all lower than those of the control group (P < 0.05). The pattern of myocardial strain and perfusion among myocardial layers was subendocardial>middle>subepicardial. The correlation coefficients of LS with A, β, and A×β were -0.500, -0.279 and -0.190, respectively, and the correlation coefficients of CS with A, β, and A×β were -0.383, -0.255 and -0.208, respectively.ConclusionsThe deformation of the three-layer myocardium and coronary microcirculation perfusion in DCM patients were diffusely damaged from the endocardium to the epicardium, layer by layer. The longitudinal function of the left ventricular myocardium was closely related to changes in myocardial microcirculation perfusion.

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The value of real-time myocardial contrast echocardiography for detecting coronary microcirculation function in coronary artery disease patients

Cited by 6 publications

References 37 publications

Comparative analysis of instantaneous wave-free ratio and quantitative real-time myocardial contrast echocardiography for the assessment of myocardial perfusion

Comparative analysis of instantaneous wave-free ratio and quantitative real-time myocardial contrast echocardiography for the assessment of myocardial perfusion

Ultrasound study of layer-specific strain and perfusion of left ventricular myocardium in patients with dilated cardiomyopathy

Ultrasound Study of Layer-specific Strain and Perfusion of Left Ventricular Myocardium in Patients With Dilated Cardiomyopathy

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