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[Evaluation of function of human collateral coronary arteries using myocardial contrast echocardiography]
1Cardiology Division, Kawachi General Hospital, Higashi-Osaka.
Insights
Myocardial contrast echocardiography visualizes collateral blood flow in patients with myocardial infarction. This technique correlates well with coronary angiography, offering a functional assessment of collateral vessels.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Context:
- Assessing coronary collateral vessel function is crucial for managing myocardial infarction.
- Coronary angiography visualizes morphology but not the functional capacity of collateral vessels.
- A need exists for a method to evaluate collateral flow in real-time.
Purpose:
- To evaluate the functional capacity of collateral vessels using myocardial contrast echocardiography (MCE).
- To correlate regional myocardial perfusion assessed by MCE with collateral vessel morphology.
- To investigate the utility of MCE in patients with old myocardial infarction.
Summary:
- Myocardial contrast echocardiography (MCE) was performed in 28 patients with old myocardial infarction.
- Intracoronary injection of agitated amidotrizoate sodium meglumine allowed visualization of collateral flow.
- Regional myocardial perfusion, quantified by enhanced gray levels, showed a general proportionality to collateral vessel morphology (poor, moderate, good).
Impact:
- MCE provides a functional assessment of collateral circulation, complementing morphological imaging.
- This technique offers a potential tool for evaluating the hemodynamic significance of coronary collaterals.
- Findings suggest MCE can aid in understanding collateral function in ischemic heart disease.
Abstract:
The morphology of collateral vessels can be imaged by coronary angiography, but no method has been available for evaluating their function. This is a report of the use of regional myocardial perfusion to visualize collateral flow by means of myocardial contrast echocardiography in 28 patients with old myocardial infarction. Myocardial contrast echocardiography was accomplished by the intracoronary injection of two ml agitated amidotrizoate sodium meglumine. Short-axis images of the left ventricle were recorded on video tape. Those images were digitized off-line into a 512 x 512 pixel matrix. Using coronary angiography, the morphology and function of the collateral vessels were evaluated, then classified as poor, moderate or good. Myocardial perfusion was evaluated using the enhanced gray level after contrast injection, and the level was compared with the morphology and degree of collateral development. The enhanced gray level was evaluated arbitrarily as 3 +/- 2 U (mean +/- S.D.) in the "poor" group; 13 +/- 6 U in the "moderate" group; and 20 +/- 11 U in the "good" group (p less than 0.01 vs the "poor" group; NS vs the "moderate" group). Regional myocardial perfusion via the collateral vessels was generally proportional to the morphology. However, there were a few discrepancies between these two parameters.