Zhang Wen Zhu, Zha Dao Gang, Cheng Guan Xun, Yang Shao Qin, Huang Xiao Bo, Qin Jian Xin, Liu Yi Li
Department of Cardiology, Nanfang Hospital, The First Military Medical University, Guangzhou, People's Republic of China.
Echocardiography. 2004 Jul;21(5):409-16. doi: 10.1111/j.0742-2822.2004.03008.x.
The aim of this study was to verify the accuracy of using myocardial contrast echocardiography (MCE), to quantify regional myocardial blood flow (MBF), and to evaluate myocardial viability in comparison to that measured by radiolabeled microsphere and pathologic examination.
Epicardial MCE was obtained in five myocardial ischemic dogs with constant microbubble intravenous infusion. After the video intensity (VI, y) versus pulsing interval plots derived from each myocardial pixel were fitted to an exponential function: y = A(1 - e(-beta t)), the MBF was calculated as the product of A (microvascular cross-sectional area or myocardial blood volume) and beta (mean myocardial microbubble velocity). The MBF was also obtained by radiolabeled microsphere method.
The MBF derived by radiolabeled microsphere method in the normal, ischemic, and infarcted region was 1.5 +/- 0.3, 0.7 +/- 0.3, and 0.3 +/- 0.2 ml/min per gram, respectively; P < 0.01. The product of A and beta in those regions was 52.5 +/- 15.1, 24.4 +/- 3.9, and 3.7 +/- 3.8, respectively; P < 0.01. The normalized product of A and beta correlated well with normalized MBF (r = 0.81, P = 0.001).
Our initial study demonstrated that MCE has an ability to assess MBF in ischemic myocardium in the experimental model. It may provide a potential capability to detect viable myocardium noninvasively after total persistent coronary occlusion in the clinical setting.
本研究旨在验证心肌对比超声心动图(MCE)用于定量局部心肌血流量(MBF)以及评估心肌存活性的准确性,并与放射性微球测量法和病理检查结果进行比较。
对五只心肌缺血犬持续静脉输注微泡,获取心外膜MCE图像。将每个心肌像素的视频强度(VI,y)与脉冲间隔关系图拟合为指数函数:y = A(1 - e(-βt)),然后将MBF计算为A(微血管横截面积或心肌血容量)与β(心肌微泡平均速度)的乘积。MBF也通过放射性微球法获得。
放射性微球法测得的正常、缺血和梗死区域的MBF分别为1.5±0.3、0.7±0.3和0.3±0.2 ml/(min·g);P<0.01。这些区域中A与β的乘积分别为52.5±15.1、24.4±3.9和3.7±3.8;P<0.01。A与β的归一化乘积与归一化MBF具有良好的相关性(r = 0.81,P = 0.001)。
我们的初步研究表明,MCE能够在实验模型中评估缺血心肌的MBF。在临床环境中,它可能具有在完全持续性冠状动脉闭塞后无创检测存活心肌的潜在能力。