Myocardial perfusion assessed by digital subtraction angiography.

Perfusion of each myocardial portion in ischemic heart disease was assessed by digital subtraction angiography (DSA). There were 45 cases of ischemic heart disease and five normal controls. The contrast medium was 40 ml 76% Urografin which was injected into the central vein at a rate of 16 ml/sec using a 5F thin-wall catheter. A myocardial image was extracted, and a time-density curve for the corresponding portion was obtained. In the normal controls, the density was maximum in systole with a gradual decrease in diastole. In all myocardial infarction cases, the wave pattern disappeared. In the group whose infarcted areas were small (26 of the 45 cases), 22 (85% of of the 26 cases) exhibited slowly increasing pattern. In the group whose infarcted areas were large (19 of the 45 cases) 15 cases (79%) had plateau type pattern. Observations of the perfusion of the myocardium using DSA facilitated quantitative diagnoses of the infarcted areas and forecasts of myocardial viability.