Changes in transmural distribution of myocardial perfusion assessed by quantitative intravenous myocardial contrast echocardiography in humans.
OBJECTIVE
To clarify whether changes in transmural distribution of myocardial perfusion under significant coronary artery stenosis can be assessed by quantitative intravenous myocardial contrast echocardiography (MCE) in humans.


METHODS
31 patients underwent dipyridamole stress MCE and quantitative coronary angiography. Intravenous MCE was performed by continuous infusion of Levovist. Images were obtained from the apical four chamber view with alternating pulsing intervals both at rest and after dipyridamole infusion. Images were analysed offline by placing regions of interest over both endocardial and epicardial sides of the mid-septum. The background subtracted intensity versus pulsing interval plots were fitted to an exponential function, y = A (1 - e(-betat)), where A is plateau level and beta is rate of rise.


RESULTS
Of the 31 patients, 16 had significant stenosis (> 70%) in the left anterior descending artery (group A) and 15 did not (group B). At rest, there were no differences in the A endocardial to epicardial ratio (A-EER) and beta-EER between the two groups (mean (SD) 1.2 (0.6) v 1.2 (0.8) and 1.2 (0.7) v 1.1 (0.6), respectively, NS). During hyperaemia, beta-EER in group A was significantly lower than that in group B (1.0 (0.5) v 1.4 (0.5), p < 0.05) and A-EER did not differ between the two groups (1.0 (0.5) v 1.2 (0.4), NS).


CONCLUSIONS
Changes in transmural distribution of myocardial perfusion under significant coronary artery stenosis can be assessed by quantitative intravenous MCE in humans.
Fukuda
S
S
Department of Internal Medicine and Cardiology, Osaka City University School of Medicine, Osaka, Japan.
Muro
T
T
Hozumi
T
T
Watanabe
H
H
Shimada
K
K
Yoshiyama
M
M
Takeuchi
K
K
Yoshikawa
J
J
D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004176:Dipyridamole; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion / Q000379:methods; D015588:Observer Variation; D011134:Polysaccharides; D014665:Vasodilator Agents
D003287:Contrast Media; D011134:Polysaccharides; D014665:Vasodilator Agents; C059891:SHU 508; D004176:Dipyridamole