Quantitative assessment of harmonic power doppler myocardial perfusion imaging with intravenous levovist™ in patients with myocardial infarction: Comparison with myocardial viability evaluated by coronary flow reserve and coronary flow pattern of infarct-related artery

被引:9
作者
Tani T. [1 ]
Tanabe K. [1 ]
Tani M. [1 ]
Ono F. [1 ]
Katayama M. [1 ]
Tamita K. [1 ]
Kaji S. [1 ]
Yamamuro A. [1 ]
Nagai K. [1 ]
Shiratori K. [1 ]
Morioka S. [1 ]
Kihara Y. [1 ]
机构
[1] Division of Cardiology, Kobe General Hospital, Chuo-ku, Kobe
关键词
Myocardial Perfusion; Myocardial Viability; Coronary Flow Reserve; Coronary Blood Flow; Myocardial Contrast Echocardiography;
D O I
10.1186/1476-7120-3-22
中图分类号
学科分类号
摘要
Background: Myocardial contrast echocardiography and coronary flow velocity pattern with a rapid diastolic deceleration time after percutaneous coronary intervention has been reported to be useful in assessing microvascular damage in patients with acute myocardial infarction. Aim: To evaluate myocardial contrast echocardiography with harmonic power Doppler imaging, coronary flow velocity reserve and coronary artery flow pattern in predicting functional recovery by using transthoracic echocardiography. Methods: Thirty patients with anterior acute myocardial infarction underwent myocardial contrast echocardiography at rest and during hyperemia and were quantitatively analyzed by the peak color pixel intensity ratio of the risk area to the control area (PIR). Coronary flow pattern was measured using transthoracic echocardiography in the distal portion of left anterior descending artery within 24 hours after recanalization and we assessed deceleration time of diastolic flow velocity. Coronary flow velocity reserve was calculated two weeks after acute myocardial infarction. Left ventricular end-diastolic volumes and ejection fraction by angiography were computed. Results: Pts were divided into 2 groups according to the deceleration time of coronary artery flow pattern (Group A; 20 pts with deceleration time ≧ 600 msec, Group B; 10 pts with deceleration time < 600 msec). In acute phase, there were no significant differences in left ventricular end-diastolic volume and ejection fraction (Left ventricular end-diastolic volume 112 ± 33 vs. 146 ± 38 ml, ejection fraction 50 ± 7 vs. 45 ± 9 %; group A vs. B). However, left ventricular end-diastolic volume in Group B was significantly larger than that in Group A (192 ± 39 vs. 114 ± 30 ml, p < 0.01), and ejection fraction in Group B was significantly lower than that in Group A (39 ± 9 vs. 52 ± 7%, p < 0.01) at 6 months. PIR and coronary flow velocity reserve of Group A were higher than Group B (PIR, at rest: 0.668 ± 0.178 vs. 0.248 ± 0.015, p < 0.0001: during hyperemia 0.725 ± 0.194 vs. 0.295 ± 0.107, p < 0.0001; coronary flow velocity reserve, 2.60 ± 0.80 vs. 1.31 ± 0.29, p = 0.0002, respectively). Conclusion: The preserved microvasculature detecting by myocardial contrast echocardiography and coronary flow velocity reserve is related to functional recovery after acute myocardial infarction. © 2005 Tani et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 23 条
[1]  
Doucette J.W., Corl P.D., Payne H.M., Validation of a Doppler guide wire for intravascular measurement of coronary artery flow velocity, Circulation, 85, pp. 1899-1911, (1992)
[2]  
Akasaka T., Yoshida K., Hozumi T., Takagi T., Kaji S., Kawamoto T., Morioka S., Yoshikawa J., Retinopathy identifies marked restriction of coronary flow reserve in patients with diabetes mellitus, J Am Coll Cardiol, 30, pp. 935-941, (1997)
[3]  
Dimitrow P.P., Transthoracic Doppler echocardiography-noninvasive diagnostic window for coronary flow reserve assessment, Cardiovascular Ultrasound, 11, (2003)
[4]  
Teiger E., Garot J., Aptecar E., Bosio P., Woscoboinik J., Pernes J.M., Gueret P., Kern M., Dubois-Rande J.L., Dupouy P., Coronary blood flow reserve and wall motion recovery in patients undergoing angioplasty for myocardial infarction, Eur Heart Journal, 20, pp. 285-292, (1999)
[5]  
Lim D.S., Kim Y.H., Lee H.S., Park C.G., Seo H.S., Shim W.J., Oh D.J., Ro Y.M., Coronary flow reserve is reflective of myocardial perfusion status in acute anterior myocardial infarction, Cathet Cardiovasc Intervent, 51, pp. 281-286, (2000)
[6]  
Rigo F., Varga Z., Di Pede F., Grassi G., Turiano G., Zuin G., Coli U., Raviele A., Picano E., Early assessment of coronary flow reserve by transthoracic Doppler echocardiography predicts late remodeling in reperfused anterior myocardial infarction, J Am Soc Echocardiogr, 17, pp. 750-755, (2004)
[7]  
Kawamto T., Yoshida K., Akasaka T., Hozumi T., Takagi T., Kaji S., Ueda Y., Can coronary blood flow velocity pattern after primary percutaneous transluminal coronary angiography predict recovery of regional left ventricular function in patients with acute myocardial infarction?, Circulation, 100, pp. 339-345, (1999)
[8]  
Shintani Y., Ito H., Iwakura K., Sugimoto K., Yamamoto K., Masuyama T., Kuzuya T., Hori M., Higashino Y., Fujii K., Prediction of wall motion recovery from the left anterior descending coronary artery velocity pattern recorded by transthoracic Doppler echocardiography in patients with anterior wall myocardial infarction. Retrospective and prospective studies, Jpn Circ J, 65, pp. 717-722, (2001)
[9]  
Cheirif J., Desir R.M., Bolli R., Mahmarian J.J., Zoghbi W.A., Verani M.S., Quinones M.A., Relation of perfusion defects observed with myocardial contrast echocardiography to the severity of coronary stenosis: Correlation with thallium-201 single-photon emission tomography, J Am Coll Cardiol, 19, pp. 1343-1349, (1992)
[10]  
Ito H., Iwakura K., Oh H., Masuyama T., Hori M., Higashino Y., Fujii K., Minamimoto T., Temporal changes in myocardial perfusion patterns in patients with reperfused anterior wall myocardial infarction. Their relation to myocardial viability, Circulation, 91, pp. 656-662, (1995)