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Myocardial contrast echocardiography. A review of clinical studies
P Widimský1, V Cervenka, P Gregor
12nd Department of Medicine, Faculty of Medical Hygiene, Charles University, Prague, Czechoslovakia.
Insights
Contrast echocardiography using microbubbles effectively visualizes myocardial perfusion. This safe, non-invasive method aids in assessing coronary stenosis, microvascular disease, and myocardial infarction.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Contrast echocardiography is an emerging technique for myocardial imaging.
- Previous studies explored its application in assessing myocardial perfusion.
- Coronary arteriography has limitations in evaluating microcirculation.
Purpose of the Study:
- To review published studies on contrast echocardiography of the myocardium.
- To evaluate the safety and efficacy of this imaging modality.
- To explore its potential applications in cardiovascular diagnostics.
Main Methods:
- Review of published studies involving 169 patients.
- Intracoronary administration of microbubble contrast agent.
- Echocardiographic imaging to assess myocardial opacification.
Main Results:
- No complications were reported during contrast echocardiography.
- Transient ECG and hemodynamic changes were minimal and short-lived.
- Myocardial opacification correlated with perfused areas, highlighting non-perfused regions.
Conclusions:
- Contrast echocardiography is a safe and promising tool for myocardial perfusion assessment.
- It can evaluate coronary stenosis significance, small artery disease, and collateral circulation.
- The method offers real-time quantification of myocardial blood flow and microcirculation.
Abstract:
A review is presented of to date published studies devoted to contrast echocardiography of the myocardium and covering a total of 169 patients. No complications occurred during investigations; slight transient ECG and haemodynamic changes of less than 30 s duration were not as pronounced as during coronary arteriography. Intracoronary administration of a 3-4 ml solution containing microbubles close to erythrocyte size leads to opacification of the perfused part of the myocardium in echocardiographic image, whereas the echogenity of nonperfused parts remains unchanged. With the use of this method it might be possible to evaluate the significance of coronary stenosis, to diagnose the "disease of small arteries", to assess the collateral circulation, myocardial infarction size, and to quantify the blood flow in various parts of the myocardium in real time. The method is promising for the assessment of myocardial microcirculation as a complement of coronary arteriography.