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

Objective: The aim of this study was to evaluate the value of real-time myocardial contrast echocardiography (RT-MCE) for detecting coronary microcirculation (CM) function in coronary artery disease (CAD) patients. Methods: Sixty-five consecutive patients were divided into CAD (n=52) and no-CAD (n=13) groups using coronary angiography (CAG). All patients underwent RT-MCE at rest and CAG within 1 week after RT-MCE. The ventricular segments in CAD patients were divided semi-quantitatively into ischemic and non-ischemic myocardial groups based on RT-MCE images. Myocardial blood volume (A), myocardial blood flow velocity (beta), and mean myocardial blood flow (A x beta) were obtained. The Gensini scores were calculated for CAD patients. The receiver operating characteristic (ROC) curve areas of A, beta, and A x beta were calculated to assess CM function in CAD patients. Results: A total of 798 and 204 segments were investigated in the CAD and non-CAD groups, respectively. In CAD patients, 332 ischemic and 466 non-ischemic segments were identified. The values of A, beta, and A x beta were significantly different among non-CAD, CAD, ischemic, and nonischemic groups. ROC curve areas of A, beta, and A x beta were 0.85, 0.79, and 0.83, respectively, and significant differences were observed in these values among three Gensini score groups of the CAD patients. Conclusion: Varying degrees of CM function deterioration was observed in CAD patients both in ischemic and non-ischemic areas, with the deterioration being more sever in the former.