Assessment of transmural distribution of myocardial perfusion with contrast echocardiography.
Assessment of transmural distribution of myocardial perfusion with contrast echocardiography.
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用对比超声心动图评估心肌灌注的透壁分布。
DOI：
10.1161/01.cir.98.18.1912
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发表时间：
1998
期刊：
影响因子：
37.8
通讯作者：
Kaul,S
中科院分区：
文献类型：
--
作者：
Linka,AZ;Sklenar,J;Wei,K;Jayaweera,AR;Skyba,DM;Kaul,S
背景-我们假设通过我们新定义的破坏微泡和测量其组织补充率的方法，我们可以评估心肌灌注的跨壁分布。方法和结果-我们研究了12只犬在静息和充血状态下制造左前降支狭窄前后(n=62)。持续注入微泡，采用不同的脉冲间隔进行心肌声学造影。每个心肌像素的视频强度-脉冲间隔曲线符合指数函数：Y=A(1−eβt)，其中A反映微血管横截面积(或心肌血容量)，β反映心肌平均微泡速度。β乘积代表心肌血流量。这些参数的平均值是从冠状动脉左前降支床上方的心内膜和心外膜感兴趣区得出的。来自相同区域的放射性标记微球来源的MBF也被测量。微球标记的MBF与心内膜/心外膜比值(EER)相关性较差(r=0.46)。与β-EER的相关性较好(r=0.69，P<；0.01)。β-EER与放射性标记微球来源的MBF-EER的相关性最好(r=0.88，P<；0.01)。结论-利用我们新描述的超声诱导的微泡破坏后微泡的组织补充方法，MCE可以准确地评估心肌灌注的跨壁分布。在所研究的模型中，在MBF-EER的逆转过程中，观察到MBF的跨壁分布与心肌血容量的解偶联。
Background—We hypothesized that by using our newly defined method of destroying microbubbles and measuring their rate of tissue replenishment, we could assess the transmural distribution of myocardial perfusion.Methods and Results—We studied 12 dogs before and after creation of left anterior descending coronary artery stenoses both at rest and during hyperemia (n=62 stages). Microbubbles were administered as a constant infusion, and myocardial contrast echocardiography (MCE) was performed with the use of different pulsing intervals. The video intensity versus pulsing interval plots derived from each myocardial pixel were fitted to an exponential function: y=A(1−eβt), whereAreflects microvascular cross-sectional area (or myocardial blood volume), andβreflects mean myocardial microbubble velocity. The productA · βrepresents myocardial blood flow (MBF). Average values for these parameters were derived from the endocardial and epicardial regions of interest placed over the left anterior descending coronary artery bed. Radiolabeled microsphere–derived MBF was also measured from the same regions. There was poor correlation between radiolabeled microsphere–derived MBF andA-endocardial/epicardial ratios (EER) (r=0.46). The correlation withβ-EER was better (r=0.69,P<0.01). The best correlation with radiolabeled microsphere–derived MBF-EER was noted withA · β-EER (r=0.88,P<0.01).Conclusions—The transmural distribution of myocardial perfusion can be accurately assessed with MCE with the use of our newly described method of tissue replenishment of microbubbles after their ultrasound-induced destruction. In the model studied, an uncoupling of the transmural distribution of MBF and myocardial blood volume was observed during reversal of the MBF-EER.