shu-508 and Coronary-Artery-Disease

Quantitative intravenous myocardial contrast echocardiography (MCE) has been shown to measure regional myocardial blood flow velocity noninvasively.. To determine whether quantitative intravenous MCE could be used clinically to predict functional recovery after revascularization in patients with chronic coronary artery disease.. Twenty-eight patients with chronic stable coronary artery disease and resting regional left ventricular dysfunction were included in this study. The study permits myocardial perfusion analysis by intravenous MCE before revascularization with continuous infusion of Levovist and intermittent ultrasonic exposure. Wall motion assessment by echocardiography at rest was repeated after long-term follow-up period (7 +/- 2 months). In dysfunctional segments, we analyzed myocardial perfusion quantitatively by fitting to an exponential function, Y = A(1 - e-betat) to obtain the rate of rise (beta) of background-subtracted intensity, which represented myocardial blood flow velocity.. Of the 101 revascularized dysfunctional segments, MCE was adequately visualized in 91 (90%) segments, and wall motion was recovered in 45 (49%) segments. The value of beta in the recovery segments was significantly higher than that in nonrecovery segments (0.80 +/- 0.50 vs 0.39 +/- 0.24, P < 0.001). The value of beta > 0.5 predicted recovery of segmental function with a sensitivity of 71%, specificity of 78%.. Quantitative intravenous MCE can predict functional recovery after revascularization in patients with chronic coronary artery disease.

Topics: Aged; Blood Flow Velocity; Chronic Disease; Contrast Media; Coronary Angiography; Coronary Artery Disease; Coronary Circulation; Echocardiography; Female; Follow-Up Studies; Humans; Injections, Intravenous; Logistic Models; Male; Middle Aged; Myocardial Revascularization; Polysaccharides; Predictive Value of Tests; Recovery of Function; Ventricular Function, Left

Transthoracic Doppler echocardiography (TTDE) allows noninvasive flow measurement in the distal left anterior descending artery (LAD). The feasibility of detecting coronary flow by contrast-enhanced TTDE with second harmonic technique was assessed, the coronary flow velocity reserve (CFVR) was evaluated in comparison to intracoronary Doppler flow (ICD) analysis and the CFVR after PTCA in LAD was investigated. In 77 (96%) of 80 patients, CFVR was successfully determined with intravenous adenosine infusion. Doppler signal quality was evaluated in the first 46 patients by use of intravenous Levovist infusion and second harmonic technique. The Doppler flow was not visible in 1. patient only. CFVR determined from TTDE (2.77 +/- 0.65) was correlated closely with those from ICD (2.88 +/- 0.78) measurements (y = 0.73x + 0.67, r = 0.87, P < 0.001). In conclusion, TTDE is a feasible method and provides reliable data on CFVR which can be used for follow-up after PTCA.

Topics: Adenosine; Adult; Aged; Blood Flow Velocity; Contrast Media; Coronary Artery Disease; Coronary Circulation; Coronary Vessels; Echocardiography, Doppler; Female; Humans; Male; Middle Aged; Polysaccharides; Predictive Value of Tests; Vasodilator Agents