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Resting Myocardial Contrast Echocardiography for the Evaluation of Coronary Microcirculation Dysfunction in Patients
Xin Li1, Sheng He1, Yun-Shan Zhang1
1Department of Ultrasound, Navy General Hospital, Beijing, China.
Insights
Resting myocardial contrast echocardiography (MCE) effectively detects coronary microcirculation dysfunction in early coronary artery disease (CAD). This noninvasive method shows significant differences in imaging times and intensity compared to controls, aiding early diagnosis and risk assessment.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Echocardiography
Background:
- Coronary microcirculation dysfunction is a potential cause of chest pain in suspected coronary artery disease (CAD).
- Early detection of microvascular dysfunction is crucial for managing patients with chest pain and potential early CAD.
Purpose of the Study:
- To evaluate the diagnostic value of resting myocardial contrast echocardiography (MCE) for early CAD.
- To assess myocardial microcirculation dysfunction using MCE parameters like continuous imaging time, peak time, and peak intensity.
Main Methods:
- Resting MCE was performed on 20 patients with early CAD and 20 healthy volunteers.
- Myocardial perfusion was subsequently evaluated using technetium 99m 2-methoxy-isobutyl-isonitrile (99mTc-MIBI) single-photon emission computed tomography (SPECT) for comparison.
Main Results:
- Patients with high CAD risk showed significantly lower peak intensity and higher peak time and continuous imaging time compared to controls (P < 0.0001).
- Resting MCE was well-tolerated with no adverse effects or hemodynamic changes.
- SPECT confirmed reversible myocardial perfusion reduction in 80% of high-risk patients.
Conclusions:
- Resting MCE is a safe and effective noninvasive tool for identifying coronary microcirculation abnormalities.
- MCE aids in the clinical assessment, risk stratification, and management of early, occult coronary artery disease.
Background:
Coronary microcirculation dysfunction can occur in patients with chest pain suggestive of coronary artery disease (CAD). The present study aimed to determine the diagnostic value of resting myocardial contrast echocardiography (MCE) for early CAD with myocardial microcirculation dysfunction by evaluating the continuous imaging time, peak time, and peak intensity.
Hypothesis:
Resting MCE is an effective and noninvasive method for evaluation of coronary microcirculation dysfunction in patients with early coronary artery disease.
Methods:
The present study included 20 consecutive patients without obvious clinical evidence of early CAD and 20 healthy volunteers. Resting MCE was performed to evaluate the myocardial microcirculation perfusion, and the follow-up evaluation of myocardial microcirculation perfusion was performed with technetium 99 m 2-methoxy-isobutyl-isonitrile ((99m) Tc-MIBI) single-photon emission computed tomography (SPECT).
Results:
Peak intensity was significantly lower in patients with high risk of CAD than in controls (P < 0.0001). The peak time and continuous imaging time were significantly higher in patients with high risk of CAD than in controls (P < 0.0001). None of the 40 subjects experienced discomfort, such as cough and chest tightness, during the resting MCE procedure, and the heart rate and blood pressure showed no abnormalities during the entire procedure. SPECT imaging showed reversible myocardial perfusion reduction in 80% (16/20) of the patients with high risk of CAD. Abnormalities of heart rate and blood pressure and adverse reactions were noted during the process of SPECT examination.
Conclusions:
Resting MCE is an effective and noninvasive method for detecting abnormalities of coronary microcirculation and can help in the clinical analysis, risk assessment, and treatment of early occult CAD.
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