Saito H, Ajima H, Suzuki M
J Cardiogr. 1984 Dec;14(4):677-88.
In the present study, myocardial contrast echocardiographic enhancement was compared with left ventricular wall motion in an experimental ischemic heart according to the degree of narrowing of the coronary artery. Artificial blood (Fluosol-DA) was used as a contrast agent. In eight adult mongrel dogs, ischemic hearts with 0, 50, 70 to 90 and 100% narrowing of the coronary artery were produced by controlling a balloon catheter in a closed-chest system. Fluosol-DA was injected into the left main coronary artery and myocardial contrast echocardiograms were recorded. The short-axis images of the left ventricle were subdivided into octants using a "floating" reference system to analyze wall motion by an image analyzer (Cardias GP2000), and to evaluate density values in the echocardiogram by densitometry (MSR Vx-50). With 0 and 50% narrowing of the coronary artery, the entire circumferential myocardium was filled with marked contrast echoes, and no change was observed in left ventricular wall motion. In 70 to 90% narrowing, the perfusion area of the narrowed coronary artery was filled with mild contrast echoes compared to the other areas showing marked contrast echoes. But no change was observed in left ventricular wall motion. During total occlusion, the perfusion area of the occluded coronary artery was not filled with contrast echoes and a distinct difference was observed between this and the other areas. Marked abnormality of wall motion was also observed. The area with abnormal wall motion tended to be wider than the area of contrast enhancement defect. The ischemic area can therefore be more accurately confirmed by simultaneously observing the changes in contrast echocardiographic enhancement and in wall motion abnormalities.
在本研究中,根据冠状动脉狭窄程度,对实验性缺血心脏的心肌对比超声心动图增强与左心室壁运动进行了比较。使用人造血液(氟碳乳剂 - DA)作为造影剂。在8只成年杂种犬中,通过在闭胸系统中控制球囊导管,制造出冠状动脉狭窄分别为0、50%、70%至90%和100%的缺血心脏。将氟碳乳剂 - DA注入左冠状动脉主干,并记录心肌对比超声心动图。使用“浮动”参考系统将左心室短轴图像细分为八分区域,通过图像分析仪(Cardias GP2000)分析壁运动,并通过光密度测定法(MSR Vx - 50)评估超声心动图中的密度值。冠状动脉狭窄0%和50%时,整个圆周心肌充满明显的对比回声,左心室壁运动未观察到变化。在70%至90%狭窄时,与显示明显对比回声的其他区域相比,狭窄冠状动脉的灌注区域充满轻度对比回声。但左心室壁运动未观察到变化。在完全闭塞期间,闭塞冠状动脉的灌注区域未充满对比回声,与其他区域之间观察到明显差异。还观察到壁运动明显异常。壁运动异常的区域往往比对比增强缺陷区域更宽。因此,通过同时观察对比超声心动图增强和壁运动异常的变化,可以更准确地确认缺血区域。