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

被引:14
作者
Lin, Yunjia [1 ]
Guan, Xin [1 ]
Ren, Kai [2 ]
Zhu, Yanbo [1 ]
Lu, Yaping [1 ]
Shang, Yanwen [1 ]
机构
[1] Tianjin Chest Hosp, Dept Ultrasound, 261 Taierzhuang South Rd, Tianjin 300222, Peoples R China
[2] Tianjin Chest Hosp, Cardiac Intens Care Unit, Tianjin 300222, Peoples R China
关键词
myocardial local microcirculation; left ventricular function; myocardial contrast echocardiography; dobutamine stress echocardiography; percutaneous coronary intervention; acute myocardial infarction; LEFT-VENTRICULAR FUNCTION; PERFUSION; INFARCTION; SAFETY; SPECT;
D O I
10.3892/etm.2020.8813
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
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), beta (the slope of the curve, reflecting the myocardial blood flow (MBF) velocity) and A x beta (reflecting MBF) of viable and non-viable myocardial segments. After being challenged by dobutamine, the values of A, beta and A x beta of normal coronary blood supply areas were significantly increased; while the segments A and A x beta 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.
引用
收藏
页码:1315 / 1320
页数:6
相关论文
共 25 条
[1]   Detection of myocardial microvascular disease using contrast echocardiography during adenosine stress in type 2 diabetes mellitus: Prospective comparison with single-photon emission computed tomography [J].
Abdelmoneim, Sahar S. ;
Basu, Ananda ;
Bernier, Mathieu ;
Dhoble, Abhijeet ;
Abdel-Kader, Samir S. ;
Pellikka, Patricia A. ;
Mulvagh, Sharon L. .
DIABETES & VASCULAR DISEASE RESEARCH, 2011, 8 (04) :254-261
[2]  
Agati L, 1997, EUR HEART J, V18, P771
[3]   Safety of myocardial flash-contrast echocardiography in combination with dobutamine stress testing for the detection of ischaemia in 5250 studies [J].
Aggeli, C. ;
Giannopoulos, G. ;
Roussakis, G. ;
Christoforatou, E. ;
Marinos, G. ;
Toli, C. ;
Pitsavos, C. ;
Stefanadis, C. .
HEART, 2008, 94 (12) :1571-1577
[4]   Potential clinical applications of myocardial contrast echocardiography in evaluating myocardial perfusion in coronary artery disease [J].
Aggeli, C ;
Bonou, M ;
Stefanadis, C .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2005, 104 (01) :1-9
[5]   Effect of gender on the prognostic value of dobutamine stress myocardial contrast echocardiography [J].
Aggeli, Constantina ;
Polytarchou, Kali ;
Felekos, Ioannis ;
Zisimos, Kostas ;
Venieri, Erifili ;
Verveniotis, Athanasios ;
Varvarousis, Dimitrios ;
Toutouzas, Kostantinos ;
Tsiamis, Eleutherios ;
Tousoulis, Dimitrios .
HELLENIC JOURNAL OF CARDIOLOGY, 2017, 58 (06) :419-424
[6]   Multimodality Imaging for Assessment of Myocardial Viability: Nuclear, Echocardiography, MR, and CT [J].
Arrighi, James A. ;
Dilsizian, Vasken .
CURRENT CARDIOLOGY REPORTS, 2012, 14 (02) :234-243
[7]   Comparison of stress dobutamine echocardiography and stress dobutamine gated myocardial SPECT for the detection of viable myocardium [J].
Asl, Mina Taghizadeh ;
Mandegar, Mohammad-Hossein ;
Roshanali, Farideh ;
Assadi, Majid .
NUCLEAR MEDICINE REVIEW, 2014, 17 (01) :18-25
[8]   Assessment of Coronary Microcirculation with Myocardial Contrast Echocardiography [J].
Danijela, Trifunovic ;
Jelena, Dudic ;
Olga, Petrovic ;
Zorana, Vasiljevic-Pokrajcic .
CURRENT PHARMACEUTICAL DESIGN, 2018, 24 (25) :2943-2949
[9]  
Fernandes H, 2011, ACTA MED PORT S4, V24, pS989
[10]   Temporal evolution and functional outcome of no reflow: sustained and spontaneously reversible patterns following successful coronary recanalisation [J].
Galiuto, L ;
Lombardo, A ;
Maseri, A ;
Santoro, L ;
Porto, I ;
Cianflone, D ;
Rebuzzi, AG ;
Crea, F .
HEART, 2003, 89 (07) :731-737