(Circulation. 2001;103:2560.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Noninvasive Quantification of Coronary Blood Flow Reserve in Humans Using Myocardial Contrast Echocardiography
Presented at the Samuel Levine Young Investigator Award Competition of the Council on Clinical Cardiology at the 73rd Annual Scientific Sessions of the American Heart Association, November 12–15, 2000, New Orleans, La, and published in abstract form (Circulation. 2000;102[suppl II]:II-H).
From the Cardiac Imaging Center and the Cardiovascular Division, University of Virginia School of Medicine, Charlottesville, Va.
Correspondence to Kevin Wei, MD, Cardiovascular Division, Box 158, Medical Center, University of Virginia, Charlottesville, VA 22908. E-mail kw6n{at}virginia.edu
Background—We hypothesized that coronary blood flow (CBF) reserve could be quantified noninvasively in humans using myocardial contrast echocardiography (MCE).
Methods and Results—Eleven patients with normal epicardial
coronary arteries (group I) and 19 with single-vessel
coronary stenosis (group II) underwent quantitative
coronary angiography, MCE, and CBF velocity measurements at
rest and during intravenous adenosine infusion. In
group I patients, MCE-derived myocardial blood flow (MBF) velocity
reserve (2.4±0.08) was similar to CBF velocity reserve using a
Doppler flow wire (2.4±1.1). Patients with a single risk
factor had a significantly higher MBF reserve (3.0±0.89) than those
with 
2 risk factors (1.7±0.22). In group II patients, significant
differences were found in MBF velocity reserve in patients with mild
(<50%), moderate (50% to 75%), or severe (>75%) stenoses
(2.2±0.40, 1.6±0.65, and 0.55±0.19, respectively;
P=0.005). A linear relation was
found between flow velocity reserve determined using the 2 methods
(r=0.76,
P<0.001), and a curvilinear
relation was noted between the percent coronary
stenosis measured using quantitative coronary
angiography and velocity reserve using both
methods.
Conclusions—CBF reserve can be measured in humans using MCE. This method may allow the noninvasive assessment of coronary stenosis severity and the detection of microvascular dysfunction.
Key Words: blood flow • coronary disease • contrast media • echocardiography
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