Myocardial contrast two-dimensional echocardiography: experimental examination at different coronary flow levels.
Myocardial contrast two-dimensional echocardiography: experimental examination at different coronary flow levels.
复制标题
心肌对比二维超声心动图：不同冠状动脉血流水平的实验检查。
DOI：
10.1016/s0735-1097(84)80180-1
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发表时间：
1984
影响因子：
24
通讯作者：
Corday,E
中科院分区：
文献类型：
--
作者：
TenCate,FJ;Drury,JK;Meerbaum,S;Noordsy,J;Feinstein,S;Shah,PM;Corday,E
在冠状动脉血供连续变化期间，用计算机二维超声心动图对八只开胸狗进行冠状动脉内注射造影剂注射后局部心肌回声对比的出现-消失进行检查。采用一种新的超声处理方法，对 50% 葡萄糖进行处理，产生微泡大小为 12 ± 6 μ（平均值 ± 标准差）的回波造影剂，并在左心室超声心动图研究期间将 1 cc 该造影剂注射到冠状动脉中。通过电磁流量计测量的左冠状动脉前降支或回旋支血流，使用血管外液压封堵器连续减少高达 90%，或者通过静脉输注双嘧达莫（7 至 10 μg/kg/min）增加 40 至 60%。对心室中短轴横截面的 12 个节段分别分析相应的心肌回声时间-强度曲线。得出心肌灌注的几个潜在指标：峰值回声对比强度、从回声对比出现到峰值强度的时间、回声对比衰减相的半衰期（T½ 和对比出现-消失的总持续时间）。除了峰值强度外，所有这些指标都在对照冠脉流量（66 ± 17 nil/min）和更大的冠脉流量之间提供了显着（p < 0.05）的区分。与从冠状动脉封堵器部位观察到的5.6±1.4个心肌节段的回声对比描绘的周向范围相比，对照状态的半衰期值为5.2±0.3秒，冠状动脉流量减少为9±2秒，双嘧达莫充血为2±2秒，大于 50% 的流量减少显着降低了 3.7 ± 1.7 节段的对比消失 T½，而中央缺血区 T½ 的收缩性壁增厚减少，与冠状动脉流量中度相关（r = 0.56，p < 0.05）。结论是，使用小微泡作为试剂的心肌对比二维超声心动图可以识别原发性灌注缺陷，并可能允许表征心肌血液。供应。
Regional myocardial echo contrast appearance-disappearance after intracoronary contrast agent injection was examined with computerized two-dimensional contrast echocardiography in eight open chest dogs during successive variation of the coronary blood supply. A new sonication method applied to dextrose 50% produced an echo contrast agent with a microbubble size of 12 ± 6 μ (mean ± standard deviation), and 1 cc of this agent was injected into a coronary artery during the echocar-diographic study of the left ventricle. Left anterior descending or circumflex coronary artery flow, measured by electromagnetic flowmeter, was successively reduced up to 90% with an extravascular hydraulic occluder, or else increased 40 to 60% through intravenous dipyridamole infusion (7 to 10 μg/kg per min). The corresponding myocardial echo time-intensity curves were analyzed for each of 12 segments of a midventricular short-axis cross section.Several potential indexes of myocardial perfusion were derived: peak echo contrast intensity, time from echo contrast appearance to peak intensity, half-life of echo contrast decay phase (T½ and total duration of contrast appearance-disappearance. Except for peak intensity, all of these indexes provided significant (p < 0.05) differentiation between control coronary flow (66 ± 17 nil/min) and greater than 50% flow reductions (26 ± 6 nil/min) or hyperemia (115 ± 17 ml/min). Half-life values were 5.2 ± 0.3 seconds for the control state, 9 ± 2 seconds for the reduced coronary flow and 2 ± 2 seconds for dipyridamole hyperemia. Compared with an echo contrast-delineated circumferential extent of 5.6 ±1.4 myocardial segments subserved from the site of the coronary occluder, greater than 50% flow reduction significantly decreased contrast disappearance T½ in 3.7 ± 1.7 segments versus decreased systolic wall thickening in 6.6 ±1.4 segments. T½ for the central ischemic zone correlated moderately with coronary flow (r = 0.56, p < 0.05).It is concluded that myocardial contrast two-dimensional echocardiography, using small microbubbles as the agent, can identify a primary perfusion defect and may permit characterization of myocardial blood supply.