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Rapid Three-Dimensional Myocardial Contrast Echocardiography: Volumetric Quantitation of Nonperfused Myocardium After
Richard Y. Bae1, Marek Belohlavek, Kazuaki Tanabe
1Ultrasound Research Laboratory, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905.
Insights
This study demonstrates a rapid 12-second 3D myocardial contrast echocardiography technique can accurately measure nonperfused heart muscle after intravenous contrast injection, avoiding invasive methods.
Area of Science:
- Cardiovascular Imaging
- Echocardiography
- Medical Technology
Background:
- Current quantitative 3D myocardial contrast echocardiography (MCE) requires lengthy acquisition times.
- This necessitates invasive contrast agent administration (intra-arterial or left atrial).
Purpose of the Study:
- To assess the feasibility of rapid 3D MCE for accurate volumetric measurement of nonperfused myocardium.
- To evaluate this technique after intravenous contrast bolus administration.
Main Methods:
- Utilized an open-chest pig model with acute left anterior descending coronary artery (LAD) occlusion.
- Administered an intravenous contrast bolus and acquired 3D images over 12 seconds using a rotating transducer.
- Assessed microbubble stability during acquisition.
Main Results:
- No significant microbubble destruction occurred during the 12-second acquisition.
- Calculated nonperfused myocardial volumes strongly correlated with anatomic specimens (r=0.89).
- Percent of nonperfused myocardium also showed high correlation (r=0.94).
Conclusions:
- Rapid 12-second 3D MCE with intravenous contrast enables accurate and precise measurement of nonperfused myocardium.
- This technique offers a less invasive alternative for assessing myocardial infarction.
- Feasible for quantitative assessment post-acute coronary artery occlusion.
Abstract:
Current acquisition methods for quantitative three-dimensional myocardial contrast echocardiography require long acquisition times and therefore require the invasive administration of deposit contrast agents administered intra-arterially or into the left atrium. This study addressed the feasibility of obtaining accurate and precise quantitative volumetric measurements of nonperfused myocardium after an intravenous bolus of echocardiographic contrast agent using a rapid three-dimensional myocardial contrast echocardiographic acquisition technique. An open-chest pig model of acute left anterior descending coronary artery (LAD) occlusion was used. After LAD ligature, an intravenous bolus of contrast agent was given and images were obtained over a 12-second period using a continuously rotating transducer placed at the apical position. There was no significant microbubble destruction during the rotational acquisition period as measured by differences in mean gray scale values of apical, mid, and basal myocardial regions between the first and last image frames of acquisition. Calculated volumes of nonperfused myocardium demonstrated significant agreement and correlation (mean difference +/- SD = -0.30 +/- 1.71 cm(3); r = 0.89; P < 0.01; y = 1.06x - 1.08) with anatomic specimens. When expressed as percent of total LV volume being nonperfused, the mean difference +/- SD was 2.1 +/- 3.6%, r = 0.94, P < 0.01, and y = 1.33x - 4.08. We conclude that accurate and precise measurements of nonperfused myocardium after an acute LAD coronary artery occlusion can be obtained after the intravenous bolus administration of a contrast material when a rapid 12-second acquisition with a continuously rotating transducer is used.