Assessment of location and size of myocardial infarction with contrast-enhanced echocardiography.
Assessment of location and size of myocardial infarction with contrast-enhanced echocardiography.
复制标题
使用对比增强超声心动图评估心肌梗塞的位置和大小。
DOI：
10.1016/s0735-1097(83)80377-5
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发表时间：
1983
影响因子：
24
通讯作者：
Harvey Feigenbaum
中科院分区：
文献类型：
--
作者：
William F. Armstrong;S. West;Thomas M. Mueller;James C. Dillon;Harvey Feigenbaum
在16只开胸犬上研究了超声造影对心肌梗塞的定位和定量能力。在基线和左前降支（n = 11）或回旋支（n = 5）冠状动脉闭塞后4小时记录常规和对比增强二维超声心动图。通过将3 ml与6 ml血液混合的0.3%过氧化氢注射到主动脉根部中来产生超声造影。还测量并量化了收缩期壁增厚，作为心肌梗死的标志物。冠状动脉闭塞4小时后处死犬。对应于二维超声心动图的左心室切片用硝基蓝四唑染色以定位梗死。用面积法测定心肌梗塞面积，用过氧化氢与血液混合产生的氧气泡在心肌内产生良好的超声造影效果。12只犬的完整数据可用。对比超声心动图准确地定位梗死在所有11只狗与梗死记录的硝基蓝四唑。梗死面积由面积测量法确定，并表示为硝基蓝四唑研究中总心肌面积的分数，与造影超声心动图确定的梗死面积相关性良好（相关系数[r] = 0.92，估计标准误[SEE] = 0.05，概率[p] < 0.001）。对比超声心动图测定梗死心肌分数的观察者内和观察者间相关性极好（分别为r = 0.93，p < 0.001，SEE = 0.04; r = 0.89，p < 0.001，SEE = 0.07）。收缩期壁增厚的情况下也准确地定位心肌梗死，但相关性差的梗死范围（r = 0.29，p =不显着）。它的结论是，对比增强二维超声心动图，使用过氧化氢和血液的组合，提供超声造影，准确和可重复定位和量化心肌梗死。
The ability of contrast-enhanced echocardiography to localize and quantify myocardial infarction was studied in 16 open chest dogs. Both routine and contrast-enhanced two-dimensional echocardiograms were recorded at baseline and 4 hours after occlusion of the left anterior descending (n = 11) or circumflex (n = 5) coronary artery. Ultrasound contrast was produced by injection into the aortic root of 3 ml of 0.3% hydrogen peroxide mixed with 6 ml blood. Systolic wall thickening was also measured and quantified as a marker of myocardial infarction. Dogs were sacrificed after 4 hours of coronary occlusion. The slice of the left ventricle that corresponded to the two-dimensional echocardiogram was stained with nitro-blue tetrazolium to localize the infarct. The size of the myocardial infarct was determined by planimetry.The oxygen bubbles produced by mixing hydrogen peroxide with blood produced an excellent intramyo-cardial ultrasound contrast effect. Complete data were available in 12 dogs. Contrast echocardiography accurately localized the infarction in all 11 dogs with an infarct documented by nitro-blue tetrazolium. The area of the infarct, determined by planimetry and expressed as a fraction of total myocardial area from the nitro-blue tetrazolium study, correlated well with the size of the infarct determined with contrast echocardiography (correlation coefficient [r] = 0.92, standard error of the estimate [SEE] = 0.05, probability [p] < 0.001). Intra-and interobserver correlations were excellent for the determination of fraction of infarcted myocardium by contrast echocardiography (r = 0.93, p < 0.001, SEE = 0.04; r = 0.89, p < 0.001, SEE = 0.07, respectively). Absence of systolic wall thickening also accurately localized myocardial infarction, but correlated poorly with the extent of infarction (r = 0.29, p = not significant).It is concluded that contrast-enhanced two-dimensional echocardiography, using a combination of hydrogen peroxide and blood to provide ultrasound contrast, accurately and reproducibly localizes and quantifies myocardial infarction.