title: Simultaneous real-time echocardiographic imaging of myocardial perfusion and regional function using color-encoded, contrast-enhanced power modulation.
abstract: We hypothesized that color-encoded, contrast-enhanced, power modulation imaging could allow simultaneous quantification of myocardial perfusion and regional left ventricular function. We studied 12 anesthetized, closed-chest pigs at baseline, during acute ischemia, and during reperfusion, and 8 patients after acute myocardial infarction. Color kinesis was used to color encode endocardial motion during real-time contrast perfusion imaging with high-energy ultrasound pulses. Wall motion was assessed by calculating regional fractional area changes. Translation-free perfusion analysis was performed in automatically identified myocardial regions of interest. Steady-state intensity and postimpulse rate of contrast replenishment were calculated. In all animals, ischemia caused reversible changes in the images and the perfusion- and function-calculated indices. A significant decrease in pixel intensity (14%) and contrast replenishment rate (66%) in left anterior descending coronary artery segments, in agreement with fluorescent microspheres measurements, coincided with a decrease in fractional area change (34%). For patients, respective perfusion and function indices were 61%, 51%, and 58% lower in segments where perfusion defects, regional wall-motion abnormalities, or both were noted in gray scale images. Color-encoded, contrast-enhanced power modulation allows simultaneous real-time imaging and quantitative analysis of myocardial perfusion and regional left ventricular function.
authors.affiliation: Department of Medicine, University of Chicago, IL 60637, USA. vmoravi@medicine.bsd.uchicago.edu
authors.forename: Victor
authors.initials: V
authors.lastname: Mor-Avi
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Korcarz
authors.forename: Keith A
authors.initials: KA
authors.lastname: Collins
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Decara
authors.forename: Enrico G
authors.initials: EG
authors.lastname: Caiani
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Lang
mesh_terms: D000818:Animals; D018618:Echocardiography, Doppler, Color; D005240:Feasibility Studies; D005466:Fluorocarbons; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008297:Male; D008863:Microspheres; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism*; D013552:Swine; D016277:Ventricular Function, Left
chemical_list: D005466:Fluorocarbons; C042852:perflutren