Value of Myocardial Contrast Echocardiography in Detecting Coronary Microcirculatory Dysfunction in Ischemia With...

Area of Science:

• Cardiology
• Medical Imaging
• Diagnostic Techniques

Background:

• Ischemia with non-obstructive coronary artery (INOCA) disease presents diagnostic challenges.
• Coronary microcirculation dysfunction (CMCD) is a key factor in INOCA.
• Accurate detection of CMCD is crucial for appropriate patient management.

Purpose of the Study:

• To evaluate the diagnostic value of myocardial contrast echocardiography (MCE) for CMCD in INOCA patients.
• To compare MCE parameters with [18F]fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) as the gold standard.
• To identify MCE parameters that best indicate CMCD.

Main Methods:

• Twenty-one INOCA patients underwent MCE and FDG PET/CT.
• Myocardial segments were classified into normal or CMCD groups based on FDG PET/CT results.
• MCE-assessed parameters (ascending slope β, time to peak TTP, A, and A×β) were analyzed.
• Receiver operating characteristic (ROC) curves were used to assess diagnostic performance.

Main Results:

• Analysis included 122 segments in the CMCD group and 218 in the control group.
• MCE parameters β, A, and A×β were significantly decreased in the CMCD group (p<0.05).
• Time to peak (TTP) was prolonged in basal segments of the CMCD group (p<0.05).
• The ascending slope (β) demonstrated the highest diagnostic efficiency in middle segments via ROC analysis.

Conclusions:

• Myocardial contrast echocardiography (MCE) is a valuable tool for diagnosing CMCD in INOCA.
• MCE can effectively identify impaired myocardial perfusion in patients with non-obstructive coronary arteries.
• The study highlights MCE's utility in the diagnostic workup of INOCA.