A Novel Agent for Contrast Echocardiography and its Evaluation in a Distinctive Clinical Application.

迄今为止，经外周静脉声学造影仅限于右心。通过手动搅拌方法制备的微泡相对太大而不能通过肺毛细血管床。因此，左心室的浑浊化一直是一个长期的梦想。随后，发现声振人血白蛋白具有许多小于10微米的小微泡，其可以通过肺毛细血管床。使用这种试剂后，左心室明显浑浊。但其乳浊效果并不是恒定的，因为自制方法产生的气泡大小不同。随着心肌声学造影技术的发展，对心肌灌注的评价不仅需要定性，而且需要定量。为了满足这样的要求，需要均匀且尺寸确定的微泡。静脉心肌造影超声心动图自最初研究通过冠状动脉内注射以来一直被期望。几种模式 ...更多信息 已经进行了PTS。然而，流入冠状动脉的微泡量太小，即使左心室腔过度浑浊，也不能清楚地显示心肌。当造影剂注入左心房腔时，左心室壁显影良好。但左心室腔内的造影剂使后方回声明显衰减。尽管彩色编码图像可用于显示低级别混浊的心室壁，但人们认为使用常规造影剂通过静脉注射使心肌混浊是困难的。最近，一种相当新的造影剂已经开发出来。即沸点低于体温，在血液中气泡稳定性高的制剂，命名为QW 3600注射液。该药剂由氟碳化合物和表面活性剂组成。该制剂在室温下为液态，但注入体内后沸腾形成微泡。在犬实验中，静脉注射0.5mg/kg以上的高剂量可使心肌明显混浊。左室腔显影消失后心肌显影持续时间较长，可能是微泡在循环过程中变大所致。高剂量组出现低血压、低氧血症等不良反应。但这种药物是相当有前途的静脉心肌声学造影。少

So far, the contrast echocardiography via peripheral vein has been limited to the right heart. The microbubbles made by a hand agitation method are relatively too large to pass through the pulmonary capillary beds. Therefore, the opacification of the left heart has been a dream for a long time. Afterwards, it was revealed that sonicated human albumin has a lot of small microbubbles under 10 microns which can pass through the pulmonary capillary bed. The left heart is definitely opacified using this agent. But the effect of its opacification is not constant, because the bubble size by home made method is various. With the progression of the myocardial contrast echocardiography, not only qualitative but also quantitative assessment of myocardial perfusion are required. To satisfy such requirements, homogeneous and sized-determined microbubbles are needed. Intravenous myocardial contrast echocardiography has been desired since the initial studies via intracoronary injection. Several attem … More pts have been made. However, the amount of microbubbles flowing into the coronary arteries is too small to opacify the myocardium clearly, even if the left ventricular cavity is opacified excessively. When a contrast agent is injected into the left atrial cavity, the left ventricular wall is opacified well. But the contrast agent in the left ventricular cavity attenuates the echo from the behind significantly. It has been thought to be difficult to opacify the myocardium via intravenous injection using conventional contrast agents, although color-coded image will useful to visualize the low grade opacified ventricular wall. Recently, a quite new contrast agent has been developed. That is the agent with lower boiling point than body temperature and high stability of bubbles in the blood ; which is named QW3600 Injection. The agent consists of fluorocarbon with surfactant. The agent is liquid state under the room temperature, but boils forming microbubbles after injected into the body. Intravenous injection of high dose over 0.5 mg/kg opacified the myocardium clearly in canine experiments. The opacification of the myocardium remained longer after disappearance of the LV cavity opacification, probably because the microbubbles might become bigger during circulation. Some side effects such as hypotension and hypoxemia occurred using high dosage. But this agent is quite promising for intravenous myocardial contrast echocardiography. Less