Shapiro J R, Xie F, Meltzer R S
Department of Medicine, University of Rochester, New York.
J Am Coll Cardiol. 1988 Sep;12(3):765-71. doi: 10.1016/0735-1097(88)90319-1.
It is controversial whether echocardiographic contrast agents prepared by sonication cause transient myocardial depression beyond that known to occur with contrast agents alone. In nine open chest dogs, contrast injections were made into the left anterior descending coronary artery during two-dimensional echocardiography. One hundred forty-four recordings were analyzed subsequently, by an observer who was unaware of other data, for percent depression of systolic wall thickening, duration of regional wall motion abnormalities, peak contrast enhancement and contrast washout. Two microbubble sizes were obtained by sonicating Renografin-76 (meglumine sodium diatrizoate): mean diameter 12 +/- 3 (SEE) and 20 +/- 6 micron. Four doses (range 0.5 to 3 ml) of each of four agents (12 and 20 micron bubbles in Renografin, nonsonicated Renografin and saline solution) were injected in random order. Significant relations were found between percent depression of systolic wall thickening, duration of regional wall motion abnormalities and contrast washout time versus microbubble size (p less than 0.001) and microbubble dose (p less than 0.01). Little increased contrast effect was found at larger doses or with larger microbubbles compared with the smaller doses and size studied. Injections of nonsonicated Renografin caused less depression of systolic wall thickening (p less than 0.05), faster resolution of wall motion abnormalities (p less than 0.05), less contrast (p less than 0.001) and more rapid contrast washout (p less than 0.001) than did 12 micron bubbles in Renografin. A significant correlation was found between the duration of regional wall motion abnormalities and contrast washout time (r = 0.93, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
通过超声处理制备的超声心动图造影剂是否会导致短暂性心肌抑制，且这种抑制超过单独使用造影剂时已知会出现的程度，这一问题存在争议。在9只开胸犬中，在二维超声心动图检查期间，将造影剂注入左前降支冠状动脉。随后，由一名不了解其他数据的观察者分析了144份记录，以观察收缩期室壁增厚的抑制百分比、局部室壁运动异常的持续时间、峰值造影增强和造影剂洗脱情况。通过对泛影葡胺-76（葡甲胺钠泛影酸盐）进行超声处理获得了两种微泡大小：平均直径为12±3（标准误差）和20±6微米。四种制剂（泛影葡胺中12微米和20微米的气泡、未超声处理的泛影葡胺和盐溶液）中的每一种均以随机顺序注射4种剂量（范围为0.5至3毫升）。发现收缩期室壁增厚的抑制百分比、局部室壁运动异常的持续时间和造影剂洗脱时间与微泡大小（p<0.001）和微泡剂量（p<0.01）之间存在显著关系。与研究的较小剂量和较小尺寸相比，较大剂量或较大微泡的造影效果几乎没有增加。与泛影葡胺中12微米的气泡相比，注射未超声处理的泛影葡胺导致收缩期室壁增厚的抑制较少（p<0.05）、室壁运动异常的消退更快（p<0.05）、造影剂较少（p<0.001）且造影剂洗脱更快（p<0.001）。发现局部室壁运动异常的持续时间与造影剂洗脱时间之间存在显著相关性（r=0.93，p<0.001）。（摘要截断于250字）
