Aronson S
Department of Anesthesia, University of Chicago, Illinois 60637.
J Card Surg. 1993 Mar;8(2 Suppl):224-7. doi: 10.1111/j.1540-8191.1993.tb01311.x.
Differentiation of reversibly stunned myocardium from irreversibly damaged (infarcted) myocardium is critically important in patient management. Current methods for monitoring myocardial function yield only nonspecific assessments of myocardial viability. On the other hand, myocardial contrast echocardiography (MCE) can be used to evaluate the extent of myocardial perfusion as well as the efficacy of myocardial protection in patients undergoing coronary artery bypass graft (CABG). This system includes an external ultrasound unit and an internal tracer, usually gaseous microbubbles, which reflect the ultrasonic beam. Previous studies have shown that myocardial risk areas identified with MCE correlate with areas defined by technetium autoradiography and infarction size. We have used MCE to evaluate coronary artery bypass patients (N = 21) with regard to myocardial function and cardioplegia perfusion patterns. A significant correlation (p < 0.01) was found between abnormal contrast enhanced cardioplegia patterns and depression of left ventricular function. Refinements to ultrasound technology and contrast agents will further enhance the diagnostic power of MCE for the quantification of myocardial blood flow.
在患者管理中，区分可逆性心肌顿抑与不可逆性损伤（梗死）心肌至关重要。当前监测心肌功能的方法仅能对心肌活力进行非特异性评估。另一方面，心肌对比超声心动图（MCE）可用于评估心肌灌注范围以及冠状动脉旁路移植术（CABG）患者的心肌保护效果。该系统包括一个外部超声装置和一种内部示踪剂，通常为气态微泡，其可反射超声束。先前的研究表明，用MCE识别出的心肌危险区域与锝自动射线照相术所界定的区域以及梗死面积相关。我们已使用MCE来评估冠状动脉旁路移植术患者（N = 21）的心肌功能和心脏停搏液灌注模式。在异常对比增强心脏停搏液模式与左心室功能降低之间发现了显著相关性（p < 0.01）。超声技术和造影剂的改进将进一步提高MCE定量心肌血流的诊断能力。
