Myocardial perfusion imaging in the setting of coronary artery stenosis and acute myocardial infarction using venous injection of a second-generation echocardiographic contrast agent.
BACKGROUND
We hypothesized that by producing excellent myocardial opacification, venous injection of FS-069 coupled with intermittent harmonic imaging (IHI) can be used to determine the presence and severity of coronary stenoses during hyperemia, the size of the risk area during coronary occlusion, and the extent of myocardial salvage after reperfusion.


RESULTS
Twelve dogs were imaged both continuously and intermittently (every end systole) in the fundamental (2 MHz) and harmonic (transmit at 2 and receive at 4 MHz) modes. FS-069 (1 mL) was injected intravenously for all stages and modes of imaging. Myocardial video intensity was severalfold (P<.01) higher during IHI than all other modes of imaging. Perfusion defects were difficult to measure during continuous and intermittent fundamental imaging and during continuous harmonic imaging. In comparison, the defects were clearly demarcated during IHI. When this mode was used, the magnitude of perfusion mismatch during hyperemia in the presence of a coronary stenosis correlated closely with the magnitude of flow mismatch when radiolabeled microspheres were used (r=.94). The perfusion defect sizes during coronary occlusion and reperfusion also correlated closely with postmortem risk area (r=.89) and infarct size (r=.96), respectively.


CONCLUSIONS
Venous injection of FS-069 coupled with IHI produces excellent myocardial opacification. This approach can be used to determine the severity of coronary stenoses during hyperemia, the size of the risk area during coronary occlusion, and the extent of myocardial salvage after reperfusion. This approach, therefore, holds promise in the clinical setting.
Firschke
C
C
Cardiovascular Division, University of Virginia School of Medicine, Charlottesville 22908, USA.
Lindner
J R
JR
Wei
K
K
Goodman
N C
NC
Skyba
D M
DM
Kaul
S
S
D000818:Animals; D003287:Contrast Media; D003326:Coronary Circulation; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004285:Dogs; D004452:Echocardiography; D006940:Hyperemia / Q000150:complications / Q000000981:diagnostic imaging; D007275:Injections, Intravenous; D008863:Microspheres; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology
D003287:Contrast Media