Assessment of Coronary Microcirculation with High Frame-Rate Contrast-Enhanced Echocardiography

Area of Science:

• Cardiovascular Imaging
• Medical Ultrasound
• Biomedical Engineering

Background:

• Assessing myocardial perfusion is crucial for acute myocardial infarction treatment.
• Echocardiography faces limitations in image quality and differentiating coronary circulation.
• Previous work developed high frame-rate contrast-enhanced ultrasound (HFR CEUS) with higher order singular value decomposition (HOSVD) for dynamic perfusion visualization.

Purpose of the Study:

• To demonstrate the capability of HFR CEUS with HOSVD in imaging perfusion deficits.
• To investigate potential false-positive contrast detection with this technique.

Main Methods:

• Utilized a porcine model with occlusion/release of the left anterior descending coronary artery.
• Employed HFR CEUS with HOSVD for data capture and offline processing during contrast agent infusion.
• Analyzed coronary flow dynamics before, during, and after occlusion release.

Main Results:

• Successfully differentiated fast and slow coronary flow, representing micro-circulation compartments.
• Observed low perfusion in the occluded area and hyperemia upon release.
• Contrast agent destruction tests confirmed actual contrast signal with minimal motion, but showed tissue signal leakage with larger motion.

Conclusions:

• HFR CEUS with HOSVD is a feasible method for assessing myocardial perfusion.
• The technique resolves flow dynamics, enabling direct evaluation of coronary flow deficits.