Shapiro J R, Reisner S A, Lichtenberg G S, Meltzer R S
Department of Anesthesiology, University of Rochester, New York.
J Am Coll Cardiol. 1990 Dec;16(7):1603-7. doi: 10.1016/0735-1097(90)90308-c.
The transmission of echocardiographic contrast medium and the cyclic changes in left ventricular videodensity during transpulmonary contrast echocardiography were investigated in nine adult volunteers with the use of intravenous injections of sonicated albumin (microbubble size 5.2 +/- 2.6 microns). Right and left ventricular and myocardial contrast were quantitated by videodensitometric analysis. The injections caused no symptoms, and no hemodynamic or electrocardiographic changes were observed. All injections resulted in right ventricular contrast. Mean peak right ventricular videodensity was 75 +/- 48 at end-diastole and 61 +/- 36 gray scale U/pixel at end-systole (p less than 0.05). Seventy-eight percent of injections resulted in left ventricular contrast with a mean peak videodensity of 21 +/- 33 gray scale U/pixel. Early systole was associated with a rapid decrease in left ventricular contrast intensity with near total disappearance of contrast by end-systole (from 23 +/- 33 and 17 +/- 23 U/pixel at end-diastole to 6 +/- 10 and 3 +/- 2 at end-systole at the left ventricular base and apex, respectively; p less than 0.05). None of the injections resulted in myocardial contrast enhancement by visual or quantitative analysis. Thus, left ventricular contrast echocardiography can be achieved after intravenous injections of sonicated albumin. Transpulmonary left ventricular contrast echocardiography is associated with near total disappearance of contrast during systole. This may be secondary to the destruction of microbubbles by the high left ventricular systolic pressure. These findings may help explain the limited success of this technique thus far for myocardial perfusion imaging.
在9名成年志愿者中，通过静脉注射超声处理的白蛋白（微泡大小为5.2±2.6微米），研究了经肺对比超声心动图检查中超声心动图造影剂的传输以及左心室视频密度的周期性变化。通过视频密度分析对右心室、左心室和心肌对比进行定量。注射未引起任何症状，未观察到血流动力学或心电图变化。所有注射均导致右心室显影。舒张末期右心室平均峰值视频密度为75±48，收缩末期为61±36灰度单位/像素（p<0.05）。78%的注射导致左心室显影，平均峰值视频密度为21±33灰度单位/像素。收缩早期左心室对比强度迅速下降，至收缩末期对比几乎完全消失（左心室底部和心尖舒张末期分别为23±33和17±23单位/像素，收缩末期分别为6±10和3±2单位/像素；p<0.05）。通过视觉或定量分析，所有注射均未导致心肌对比增强。因此，静脉注射超声处理的白蛋白后可实现左心室对比超声心动图检查。经肺左心室对比超声心动图检查在收缩期对比几乎完全消失。这可能继发于高左心室收缩压对微泡的破坏。这些发现可能有助于解释该技术目前在心肌灌注成像方面取得有限成功的原因。
