Vandenberg B F, Kieso R, Fox-Eastham K, Chilian W, Kerber R E
Department of Internal Medicine, University of Iowa, Iowa City 52242.
J Am Coll Cardiol. 1989 Jan;13(1):200-6. doi: 10.1016/0735-1097(89)90571-8.
Hand-agitated diatrizoate meglumine/diatrizoate sodium (MD-76) was injected above the aortic valve in seven dogs during two-dimensional echocardiographic imaging to determine the ability of contrast appearance variables (i.e., peak background-subtracted gray level intensity, time to peak contrast appearance and maximal slope of the contrast appearance curve) to predict myocardial blood flow. Regional perfusion was altered by a critical coronary stenosis (around the left anterior descending coronary artery) or by administering intracoronary adenosine (into the left circumflex coronary artery), or both. Changes in regional blood flow between control and interventions were compared with the changes in the contrast appearance variables. In addition, the ability of intracyclic variability of gray level intensity to predict myocardial perfusion was assessed. In the determination of absolute myocardial perfusion, background-subtracted peak gray level intensity and the maximal slope of the appearance curve demonstrated a fair correlation (r = 0.67 and 0.51, respectively, p less than 0.0001). However, time to peak contrast appearance did not correlate (r = 0.14, p = 0.31). Intracyclic variability of gray level intensity at control (before contrast injection) and after contrast injection also did not correlate with perfusion (r = 0.18 and 0.06, respectively). In the evaluation of relative changes in myocardial blood flow, the percent change in the maximal slope of the appearance curve correlated with the percent change in blood flow (r = 0.77, p less than 0.0001). Seven of the eight regions with greater than 3.5-fold increase in blood flow were identified by an increase in maximal slope of greater than 50%.(ABSTRACT TRUNCATED AT 250 WORDS)
在七只狗进行二维超声心动图成像期间，将手动搅拌的泛影葡胺/泛影酸钠（MD - 76）注入主动脉瓣上方，以确定对比剂显影变量（即背景扣除后的峰值灰度强度、对比剂显影峰值时间和对比剂显影曲线的最大斜率）预测心肌血流的能力。通过严重冠状动脉狭窄（围绕左前降支冠状动脉）或冠状动脉内给予腺苷（注入左旋支冠状动脉）或两者同时进行，改变局部灌注。将对照和干预之间局部血流的变化与对比剂显影变量的变化进行比较。此外，评估灰度强度的心动周期内变异性预测心肌灌注的能力。在绝对心肌灌注的测定中，背景扣除后的峰值灰度强度和显影曲线的最大斜率显示出较好的相关性（分别为r = 0.67和0.51，p < 0.0001）。然而，对比剂显影峰值时间无相关性（r = 0.14，p = 0.31）。对照时（对比剂注射前）和对比剂注射后灰度强度的心动周期内变异性也与灌注无相关性（分别为r = 0.18和0.06）。在评估心肌血流的相对变化时，显影曲线最大斜率的百分比变化与血流百分比变化相关（r = 0.77，p < 0.0001）。血流增加超过3.5倍的八个区域中的七个，通过最大斜率增加超过50%得以识别。（摘要截断于250字）
