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Myocardial perfusion assessed by digital subtraction angiography
Insights
Digital subtraction angiography (DSA) effectively assessed myocardial perfusion in ischemic heart disease. DSA revealed distinct patterns in infarction cases, aiding in quantitative diagnosis and viability assessment.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Ischemic heart disease poses a significant global health challenge.
- Accurate assessment of myocardial perfusion is crucial for diagnosis and treatment planning.
- Digital subtraction angiography (DSA) offers a potential method for evaluating regional myocardial blood flow.
Purpose of the Study:
- To evaluate the utility of digital subtraction angiography (DSA) in assessing myocardial perfusion in patients with ischemic heart disease.
- To differentiate perfusion patterns between normal controls and patients with myocardial infarction.
- To correlate DSA findings with the extent and characteristics of myocardial infarction.
Main Methods:
- 45 patients with ischemic heart disease and 5 normal controls underwent DSA.
- Contrast medium (76% Urografin) was injected intravenously via a 5F catheter.
- Myocardial images were analyzed to generate time-density curves for regional perfusion assessment.
Main Results:
- Normal controls showed peak density during systole with a diastolic decrease.
- Myocardial infarction cases exhibited a loss of the typical wave pattern.
- Small infarcts (26 cases) often showed a slowly increasing pattern (85% of cases).
- Large infarcts (19 cases) frequently presented a plateau pattern (79% of cases).
Conclusions:
- DSA provides a quantitative method for assessing myocardial perfusion in ischemic heart disease.
- Observed perfusion patterns correlate with the size of infarcted areas.
- DSA facilitates diagnosis of infarct extent and prognosis of myocardial viability.
Abstract:
Perfusion of each myocardial portion in ischemic heart disease was assessed by digital subtraction angiography (DSA). There were 45 cases of ischemic heart disease and five normal controls. The contrast medium was 40 ml 76% Urografin which was injected into the central vein at a rate of 16 ml/sec using a 5F thin-wall catheter. A myocardial image was extracted, and a time-density curve for the corresponding portion was obtained. In the normal controls, the density was maximum in systole with a gradual decrease in diastole. In all myocardial infarction cases, the wave pattern disappeared. In the group whose infarcted areas were small (26 of the 45 cases), 22 (85% of of the 26 cases) exhibited slowly increasing pattern. In the group whose infarcted areas were large (19 of the 45 cases) 15 cases (79%) had plateau type pattern. Observations of the perfusion of the myocardium using DSA facilitated quantitative diagnoses of the infarcted areas and forecasts of myocardial viability.