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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Myocardial perfusion echocardiography and coronary microvascular dysfunction

Giuseppe Barletta1, Maria Riccarda Del Bene1

  • 1Giuseppe Barletta, Maria Riccarda Del Bene, Cardio-Thoracic and Vascular Department, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, 50134 Florence, Italy.

World Journal of Cardiology
|January 6, 2016
PubMed

Insights

Myocardial contrast echocardiography (MCE) enhances the assessment of coronary microcirculation and myocardial perfusion, offering insights into ischemic heart disease beyond epicardial blockages.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Cardiovascular Physiology

Background:

  • Coronary syndromes understanding has shifted from epicardial atherosclerosis to include coronary microcirculation abnormalities.
  • Direct visualization of coronary microcirculation remains challenging, necessitating functional assessment methods.
  • Myocardial contrast echocardiography (MCE) emerged as a key technique for evaluating myocardial perfusion.

Purpose of the Study:

  • To highlight the role of Myocardial Contrast Echocardiography (MCE) in assessing coronary microcirculation.
  • To demonstrate MCE's capability in quantifying myocardial perfusion and coronary blood flow.
  • To evaluate MCE's diagnostic performance compared to established methods for microvascular dysfunction.

Main Methods:

  • Utilized quantitative Myocardial Contrast Echocardiography (MCE) for assessing myocardial perfusion abnormalities.
  • Integrated MCE with fractional flow reserve (FFR) to define ischemic burden and collateral contribution.
  • Compared MCE diagnostic performance against Positron Emission Tomography (PET) for microvascular reserve.

Main Results:

  • Quantitative MCE and FFR integration improved the definition of ischemic burden in non-critical stenosis.
  • MCE identified no-reflow and low-flow phenomena in myocardial infarction, predicting myocardial recovery.
  • MCE demonstrated diagnostic performance comparable to PET in assessing microvascular reserve and dysfunction.

Conclusions:

  • Myocardial contrast echocardiography (MCE) significantly improves echocardiographic evaluations of ischemic heart disease.
  • MCE provides valuable functional insights into coronary microcirculation and myocardial perfusion.
  • Further regulatory approval is needed for widespread clinical adoption of MCE in daily practice.

Keywords:
Contrast echocardiographyCoronary flowMicrovascular anginaMyocardial ischemiaMyocardial perfusion

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