title: Myocardial washout of sonicated iopamidol reflects coronary blood flow in the absence of autoregulation.
abstract: OBJECTIVE
  The aim of the study was to evaluate the relation between measurements derived from myocardial contrast echocardiography and coronary blood flow.
  
  
  BACKGROUND
  Contrast echocardiography has the potential for measuring blood flow.
  
  
  METHODS
  In six open chest anesthetized dogs, the left circumflex coronary artery was cannulated and perfused with blood drawn from the left femoral artery. While adenosine was infused into the circuit, circumflex flow was generated by a calibrated roller pump to the point of abolishing coronary autoregulation. At each of 25 levels of coronary blood flow, paired bolus injections of sonicated iopamidol were performed proximal to a mixing chamber. The perfused area of the left circumflex coronary artery was labeled by radioactive microspheres injected into the perfusion line. Two-dimensional echocardiographic images of the left ventricular short axis were digitized off-line, and myocardial videodensity was measured in the area perfused by the left circumflex coronary artery to generate time-intensity curves.
  
  
  RESULTS
  The washout slope of curves showed a good correlation with coronary blood flow, ranging from 0.5 to 12.5 ml/min per g of tissue. This correlation was good both in individual dogs (correlation coefficient [r] ranging from 0.78 to 0.96) and in the group of animals as a whole (r = 0.85). Washout slope also showed a good correlation with coronary diastolic pressure (r = 0.80), which ranged from 23 to 114 mm Hg, suggesting a possible primary effect of pressure on contrast washout. However, coronary blood flow appeared to be a stronger predictor of washout slope (partial F = 26.5, p < 0.001) than did perfusion pressure (partial F = 5.9, p < 0.05 by multiple regression). The injection to injection variability in myocardial washout slope appeared to be high (24%). The gamma variate fitting of curves did not improve the correlation with coronary flow (r = 0.78).
  
  
  CONCLUSIONS
  Myocardial washout of sonicated iopamidol reflects coronary blood flow in a model in which coronary autoregulation is abolished.
authors.affiliation: CNR (Consiglio Nazionale Ricerche) Clinical Physiology Institute and University of Pisa, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Rovai
authors.forename: G
authors.initials: G
authors.lastname: Ghelardini
authors.forename: M
authors.initials: M
authors.lastname: Lombardi
authors.forename: M G
authors.initials: MG
authors.lastname: Trivella
authors.forename: E
authors.initials: E
authors.lastname: Nevola
authors.forename: L
authors.initials: L
authors.lastname: Taddei
authors.forename: C
authors.initials: C
authors.lastname: Michelassi
authors.forename: A
authors.initials: A
authors.lastname: Distante
authors.forename: A N
authors.initials: AN
authors.lastname: DeMaria
authors.forename: A
authors.initials: A
authors.lastname: L'Abbate
mesh_terms: D000241:Adenosine / Q000008:administration & dosage; D000818:Animals; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D003326:Coronary Circulation / Q000187:drug effects; D004285:Dogs; D004452:Echocardiography / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006706:Homeostasis / Q000187:drug effects; D007479:Iopamidol / Q000008:administration & dosage / Q000493:pharmacokinetics; D016018:Least-Squares Analysis; D008297:Male; D008863:Microspheres; D009206:Myocardium / Q000378:metabolism*; D012044:Regression Analysis; D013010:Sonication; D013997:Time Factors
chemical_list: D007479:Iopamidol; D000241:Adenosine