title: Quantitative assessment of myocardial blood flow by contrast two-dimensional echocardiography: initial clinical observations.
abstract: Myocardial contrast two-dimensional echocardiography (MC-2DE) is a new technique to study myocardial perfusion imaging. Whether quantitative analysis of MC-2DE has any clinical significance is not known. We studied 12 patients during cardiac catheterization and coronary arteriography by MC-2DE, using sonicated iopamidol (microbubble size 12 +/- 4 micron) as the echocontrast agent. Selective intracoronary injections of 4 cc were performed into the left and right coronary artery. Two-dimensional echocardiograms were made before, during, and after injection from the apical four-chamber view. The coronary artery stenosis was calculated by automated boundary detection from the digitized cine arteriograms and expressed as percentage area stenosis (%S); also the absolute minimal luminal area (L) was calculated. From the MC-2DE video images, end-diastolic frames were chosen for digitization and videointensity measured from a region of interest at basal or midseptal level. This analysis reveals a curve of echo intensity versus time. From these curves, total curve area (A), curve duration (T), and time from peak intensity to 50% intensity decay (T50) were measured. Multiple regression analysis reveals the best correlation between %S and A (A = 52.48. e0.02%S; P less than .0001; r = 0.89). Correlations between %S, L, and T and T50, respectively, were less. Thus MC-2DE quantitative analysis shows a good agreement with anatomical size of coronary artery stenosis. These findings might have important clinical implications for future follow-up of various therapeutic procedures such as transluminal angioplasty thrombolysis.
authors.affiliation: Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.
authors.forename: F J
authors.initials: FJ
authors.lastname: ten Cate
authors.forename: J H
authors.initials: JH
authors.lastname: Cornel
authors.forename: P W
authors.initials: PW
authors.lastname: Serruys
authors.forename: W B
authors.initials: WB
authors.lastname: Vletter
authors.forename: J
authors.initials: J
authors.lastname: Roelandt
authors.forename: W H
authors.initials: WH
authors.lastname: Mittertreiner
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D003326:Coronary Circulation; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006321:Heart / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D003287:Contrast Media