title: Intracoronary and aortic root myocardial contrast echocardiography: the effect of route, dose, and pharmacologic coronary vasodilation.
abstract: Myocardial contrast echocardiography is useful for the assessment of myocardial perfusion but has required direct intracoronary injections. Aortic root myocardial contrast echocardiography has the potential advantage of allowing simultaneous assessment of multiple perfusion beds, as well as evaluating competitive and collateral flows. This study assessed the safety and efficacy of intracoronary and aortic root injections of sonicated 5% human serum albumin (Albunex) with and without concomitant coronary vasodilation. Without vasodilation, 72% of intracoronary injections had optimal myocardial enhancement, compared with 21% of aortic root injections. For individual patients, significant dose-response relationships existed for both intracoronary and aortic root injections, although contrast intensity for a given dose varied between patients. Pharmacologic vasodilation resulted in significant increases in contrast intensity and in the incidence of optimal myocardial contrast after aortic root injections. Aortic root myocardial contrast echocardiography potentially allows the simultaneous assessment of multiple perfusion beds through a route somewhat less invasive than that of direct intracoronary injections.
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Bach
authors.forename: W F
authors.initials: WF
authors.lastname: Armstrong
authors.forename: T
authors.initials: T
authors.lastname: Collins
authors.forename: D W
authors.initials: DW
authors.lastname: Muller
authors.forename: S R
authors.initials: SR
authors.lastname: Ramee
authors.forename: D E
authors.initials: DE
authors.lastname: Bruns
authors.forename: J
authors.initials: J
authors.lastname: Cheirif
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins / Q000008:administration & dosage; D001011:Aorta / Q000000981:diagnostic imaging* / Q000187:drug effects; D003097:Collateral Circulation; D003287:Contrast Media / Q000008:administration & dosage*; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000187:drug effects; D004176:Dipyridamole / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007269:Injections, Intra-Arterial; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D015588:Observer Variation; D012449:Safety; D016037:Single-Blind Method; D014664:Vasodilation; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D000418:Albumins; C060687:Albunex; D003287:Contrast Media; D014665:Vasodilator Agents; D004176:Dipyridamole