From the Cardiovascular Division, University of Virginia School of
Medicine (Charlottesville).
Correspondence to Sanjiv Kaul, MD, Cardiovascular Division, Medical Center, Box 158, University of Virginia, Charlottesville, VA 22908. E-mail sk{at}virginia.edu
Background—Ultrasound can cause
microbubble destruction. If microbubbles are administered as a
continuous infusion, then their destruction within the
myocardium and measurement of their myocardial reappearance
rate at steady state will provide a measure of mean myocardial
microbubble velocity. Conversely, measurement of their myocardial
concentration at steady state will provide an assessment of
microvascular cross-sectional area. Myocardial blood flow (MBF) can
then be calculated from the product of the two.
Methods and Results—Ex vivo and in vitro experiments were
performed in which either flow was held constant and pulsing interval
(interval between microbubble destruction and replenishment) was
altered, or vice versa. In vivo experiments were performed in 21 dogs.
In group 1 dogs (n=7), MBF was mechanically altered in a model in which
coronary blood volume was constant. In group 2 dogs (n=5), MBF
was altered by direct coronary infusions of vasodilators. In
group 3 dogs (n=9), non–flow-limiting coronary
stenoses were created, and MBF was measured before and after
the venous administration of a coronary vasodilator. In all
experiments, microbubbles were delivered as a constant infusion, and
myocardial contrast echocardiography was performed
using different pulsing intervals. The myocardial video intensity
versus pulsing interval plots were fitted to an exponential function:
y=A(1-e-ßt),
where A is the plateau video intensity reflecting the
microvascular cross-sectional area, and ß reflects the rate of rise
of video intensity and, hence, microbubble velocity. Excellent
correlations were found between flow and ß, as well as flow and the
product of A and ß.
Conclusions—MBF can be quantified with myocardial contrast
echocardiography during a venous infusion of
microbubbles. This novel approach has potential for measuring tissue
perfusion in any organ accessible to ultrasound.
© 1998 American Heart Association, Inc.
Basic Science Reports
Quantification of Myocardial Blood Flow With Ultrasound-Induced Destruction of Microbubbles Administered as a Constant Venous Infusion
Key Words: echocardiography • contrast media • blood flow • microcirculation
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