Myocardial contrast echocardiography in acute myocardial infarction using aortic root injections of microbubbles in conjunction with harmonic imaging: potential application in the cardiac catheterization laboratory.
Myocardial contrast echocardiography in acute myocardial infarction using aortic root injections of microbubbles in conjunction with harmonic imaging: potential application in the cardiac catheterization laboratory.
复制标题
使用主动脉根部注射微泡结合谐波成像进行急性心肌梗死的心肌造影超声心动图：在心导管插入术实验室中的潜在应用。
DOI：
10.1016/s0735-1097(96)00426-3
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发表时间：
1997
影响因子：
24
通讯作者：
Kaul,S
中科院分区：
文献类型：
--
作者：
Firschke,C;Lindner,JR;Goodman,NC;Skyba,DM;Wei,K;Kaul,S
目标。本研究的目的是评估实验性急性心肌梗死使用主动脉根部注射与谐波成像的心肌造影剂超声心动图，以确定该方法在心导管实验室中的潜力。在急性心肌梗死患者心导管插入术时，需要一种辅助程序来评估心肌灌注。主动脉根部单次注射造影剂可提供心脏横切面心肌灌注的完整信息。高质量的图像将提供心肌灌注的在线评估，而无需求助于图像处理。这些数据对于确定患者的治疗方法非常有价值。对9只开胸犬在冠状动脉闭塞和冠状动脉再灌注时的心肌超声造影灌注缺陷进行测量，采用连续和间歇模式的基波和谐波成像。将这些缺陷与ct -99m自显像上的危险区域和组织染色上的梗死面积进行比较。与主动脉根部注射造影剂后的基本成像相比，谐波成像使心肌视频强度增加了两倍以上（p < 0.001），间歇成像并不优于连续成像。改进的谐波成像信噪比允许在线定义危险区域（r = 0.98）和梗死面积（r = 0.93），而无需求助于离线处理。只有离线处理后，基础成像才能获得类似的结果。主动脉根部注射造影剂结合谐波成像可用于提供急性心肌梗死期间危险区域和梗死面积的准确在线评估。这些结果对导管实验室具有重要意义。[J] .中华心血管病杂志，1997;29:27 - 16
Objectives. The aim of this study was to evaluate myocardial contrast echocardiography using aortic root injections with harmonic imaging in experimental acute myocardial infarction to determine the potential of this approach in the cardiac catheterization laboratory.Background. It would be desirable to have an adjunctive procedure that could evaluate myocardial perfusion at the time of cardiac catheterization in patients with acute myocardial infarction. A single injection of contrast medium in the aortic root would provide complete information on myocardial perfusion in a cross section of the heart. High quality images would provide on-line assessment of myocardial perfusion without recourse to image processing. These data could be very valuable for determining patient management.Methods. Perfusion defects on myocardial contrast echocardiography were measured during coronary occlusion and reflow, using fundamental and harmonic imaging in both continuous and intermittent modes in nine open chest dogs. These defects were compared with risk area on technetium-99m autoradiography and infarct size on tissue staining.Results. Whereas harmonic imaging increased myocardial video intensity by more than twofold (p < 0.001) compared with fundamental imaging after aortic root injection of contrast medium, intermittent imaging was not superior to continuous imaging. The improved signal to noise ratio of harmonic imaging allowed on-line definition of risk area (r = 0.98) and infarct size (r = 0.93) without recourse to off-line processing. Similar results could be obtained with fundamental imaging only after off-line processing.Conclusions. Aortic root injections of contrast medium coupled with harmonic imaging can be used to provide accurate on-line assessment of risk area and infarct size during acute myocardial infarction. These results have important implications for the catheterization laboratory.(J Am Coll Cardiol 1997;29:207–16)>