Armstrong W F, Gage S W
Wishard Memorial Hospital, Krannert Institute of Cardiology, Indianapolis, IN 46202.
J Am Soc Echocardiogr. 1988 Sep-Oct;1(5):322-32. doi: 10.1016/s0894-7317(88)80006-3.
In this study we used myocardial contrast echocardiography to evaluate reperfusion hyperemia in an open-chest canine model of temporary coronary artery occlusion. Eight dogs had coronary occluders and electromagnetic flow probes on the left circumflex coronary artery. Aortic root injections of agitated sodium diatrizoate and saline solution were used for myocardial contrast. Data were collected at baseline (n = 16), during coronary occlusion (n = 18), immediately after coronary release (n = 18), and 5 minutes after coronary artery release (n = 12). Baseline coronary flow was 23.8 +/- 5.9 ml/min, decreasing to 0 ml/min during coronary occlusion. Immediately after coronary release flow was 96.6 +/- 41 ml/min (p less than 0.001 compared with baseline), and 5 minutes after coronary release flow was 68.2 +/- 27.9 ml/min (p less than 0.001 compared with baseline). The myocardial image intensity change after injection of contrast material was 74.25 +/- 30.6 ml/min at baseline and declined to 10.4 +/- 10.9 ml/min during coronary occlusion (p less than 0.001 compared with baseline). During reperfusion hyperemia image intensity change was 102.3 +/- 33.3 ml/min (p less than 0.001 compared with occlusion, p less than 0.02 compared with baseline, p less than 0.001 compared with remote regions). Considering all observations, myocardial image intensity change after contrast injection correlated positively with coronary flow (r = 0.67, p less than 0.001). Correlations within individual dogs ranged from r = 0.70 to 0.98. We conclude that image intensity change after aortic root injection of echocardiographic contrast correlates with coronary blood flow. Objective measurements of contrast intensity reflect increases in coronary flow associated with reactive hyperemia after coronary occlusion and release.
在本研究中，我们使用心肌对比超声心动图来评估临时冠状动脉闭塞的开胸犬模型中的再灌注充血情况。八只犬的左旋冠状动脉上放置了冠状动脉封堵器和电磁血流探头。通过向主动脉根部注射搅拌过的泛影葡胺钠和盐溶液来进行心肌对比。在基线时（n = 16）、冠状动脉闭塞期间（n = 18）、冠状动脉松开后即刻（n = 18）以及冠状动脉松开后5分钟（n = 12）收集数据。基线冠状动脉血流为23.8±5.9 ml/min，冠状动脉闭塞期间降至0 ml/min。冠状动脉松开后即刻血流为96.6±41 ml/min（与基线相比，p<0.001），冠状动脉松开后5分钟血流为68.2±27.9 ml/min（与基线相比，p<0.001）。注射对比剂后心肌图像强度变化在基线时为74.25±30.6 ml/min，冠状动脉闭塞期间降至10.4±10.9 ml/min（与基线相比，p<0.001）。在再灌注充血期间，图像强度变化为102.3±33.3 ml/min（与闭塞相比，p<0.001；与基线相比，p<0.02；与远隔区域相比，p<0.001）。综合所有观察结果，注射对比剂后心肌图像强度变化与冠状动脉血流呈正相关（r = 0.67，p<0.001）。各只犬的相关性范围为r = 0.70至0.98。我们得出结论，经主动脉根部注射超声心动图对比剂后的图像强度变化与冠状动脉血流相关。对比强度的客观测量反映了冠状动脉闭塞和松开后与反应性充血相关的冠状动脉血流增加。
