Circulation, Vol 85, 1557-1564, Copyright © 1992 by American Heart Association
FS Villanueva, WP Glasheen, J Sklenar, AR Jayaweera and S Kaul
BACKGROUND. Myocardial contrast echocardiography currently involves
intro-arterial injection of contrast. For this technique to have a broader
application, it is necessary that myocardial opacification be achieved from
a venous injection of contrast. METHODS AND RESULTS. To achieve myocardial
opacification after right-side injection of contrast, two groups of
open-chest anesthetized dogs were studied. Group 1 included nine dogs in
whom microbubbles of various sizes, concentrations, and volumes were
injected into the left atrium to determine microbubble characteristics that
influence myocardial opacification. Group 2 included eight dogs in whom the
effect of the combination of microbubble characteristics and myocardial
blood flow on myocardial opacification was evaluated after right atrial
injection of contrast. Background-subtracted time-intensity plots were
generated from the myocardium to measure peak videointensity. In the group
2 dogs, digital subtraction and color coding were used to further highlight
the contrast effect. The number, concentration, and size of the
microbubbles all independently affected (p less than 0.01) peak myocardial
videointensity after left atrial injection of contrast on multivariate
analysis. Highly concentrated microbubbles (4.4 to 5.1 billion/ml) given
during dipyridamole-induced coronary hyperemia was most frequently (88%)
associated with myocardial opacification after right atrial injection of
contrast and was the best predictor of this result on multivariate analysis
(chi 2= 9.01, p = 0.003). No changes were noted in left atrial, left
ventricular, and pulmonary artery pressures despite injection of large
numbers of microbubbles into the right atrium. CONCLUSIONS. Successful and
reproducible myocardial opacification can be achieved during myocardial
contrast echocardiography after right atrial injection of contrast. These
findings could have far-reaching implications in the use of myocardial
contrast echocardiography in acute and chronic ischemic syndromes in
humans.
ARTICLES
Successful and reproducible myocardial opacification during two- dimensional echocardiography from right heart injection of contrast
Department of Medicine, University of Virginia School of Medicine, Charlottesville.
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