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Alvarez E, Dalton ND, Gu Y, Smith D, Luong A, Hoshijima M, Peterson KL, Rychak J. A novel method for quantitative myocardial contrast echocardiography in mice. Am J Physiol Heart Circ Physiol 2017; 314:H370-H379. [PMID: 29127239 DOI: 10.1152/ajpheart.00568.2017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The small size of the mouse heart frequently imparts technical challenges when applying conventional in vivo imaging methods for assessing heart function. Here, we describe the use of high-frequency ultrasound imaging in conjunction with a size-tuned blood pool contrast agent for quantitatively assessing myocardial perfusion in living mice. A perflurocarbon microbubble formulation exhibiting a narrow size distribution was developed, and echogenicity was assessed at 18 MHz in vitro. Adult mice were subjected to permanent ligation of the left anterior descending artery. Ultrasound imaging was performed on day 7, and a cohort of intact mice was used as a control. Parasternal long-axis cine clips were acquired at 18 MHz before and after contrast administration. Reduced ejection fraction and increased end-systolic volume were observed in infarcted compared with control mice. In control animals, washin of the contrast agent was visible in all myocardial segments. Reduced contrast enhancement was observed in apical-posterolateral regions of all infarcted mice. A novel method for reslicing of the imaging data through the time domain provided a two-dimensional presentation of regional contrast agent washin, enabling convenient identification of locations exhibiting altered perfusion. Myocardial segments exhibiting diminished contractility were observed to have correspondingly low relative myocardial perfusion. The contrast agent formulation and methods demonstrated here provide the basis for simplifying routine in vivo estimation of infarct size in mice and may be particularly useful in longitudinal evaluation of revascularization interventions and assessment of peri-infarct ischemia. NEW & NOTEWORTHY Murine myocardial contrast echocardiography frequently suffers from poor sensitivity to contrast. Here, we formulated a novel size-tuned microbubble contrast agent and validated it for use with ultra-high-frequency ultrasound. A novel data method for evaluating myocardial perfusion based on reslicing the imaging data through the time domain is presented.
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Affiliation(s)
- E Alvarez
- Department of Medicine, University of California , San Diego, California
| | - N D Dalton
- Department of Medicine, University of California , San Diego, California
| | - Y Gu
- Department of Medicine, University of California , San Diego, California
| | - D Smith
- Targeson, Incorporated, San Diego, California
| | - A Luong
- Targeson, Incorporated, San Diego, California
| | - M Hoshijima
- Department of Medicine, University of California , San Diego, California
| | - K L Peterson
- Department of Medicine, University of California , San Diego, California
| | - J Rychak
- Department of Bioengineering, University of California , San Diego, California.,Targeson, Incorporated, San Diego, California
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Jiang L, Yao H, Liang ZG. Postoperative Assessment of Myocardial Function and Microcirculation in Patients with Acute Coronary Syndrome by Myocardial Contrast Echocardiography. Med Sci Monit 2017; 23:2324-2332. [PMID: 28514327 PMCID: PMC5443357 DOI: 10.12659/msm.901233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Postoperative myocardial function and microcirculation of acute coronary syndrome (ACS) was assessed by myocardial contrast echocardiography (MCE). MATERIAL AND METHODS Eighty-nine ACS patients treated with percutaneous coronary intervention (PCI) were detected by MCE and two-dimensional ultrasonography before and a month later after PCI respectively. Their myocardial perfusion was evaluated by myocardial contrast score (MSC) and contrast score index (CSI); cross-sectional area of microvessel (A), average myocardial microvascular impairment (β), and myocardial blood flow (MBF) were analyzed by cardiac ultrasound quantitative analysis (CUSQ), and fractional flow reserve (FFR) change was observed. Left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), and left ventricular end-systolic dimension (LVESD) were observed; the index of microcirculatory resistance (IMR), FFR, and coronary flow reserve (CFR) were detected to evaluate coronary microcirculation. RESULTS None of the 89 patients experienced no-reflow. Patients with normal myocardial perfusion mostly had normal or slightly decreased ventricular wall motion after PCI. A month after the operation, there was an increase in A, β, MBF, LVEF, E/A, IMR, FFR, and CFR (all P<0.05), while LVEDD, LVESD, diastolic gallop A peak, E/Ea, E/Ea×S, and Tei decreased (all P<0.05). LVEF and IMR were in positive correlations with A. LVEF, IMR, FFR and CFR were positively correlated with b and MBF (both r>0, P<0.05), while E/Ea×Sa and Tei were negatively correlated with b and MBF (r<0, P<0.05). CONCLUSIONS MCE can safely assess post-PCI myocardial function and microcirculation of ASC.
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Affiliation(s)
- Li Jiang
- Department of Hematology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China (mainland)
| | - Hong Yao
- Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Zhao-Guang Liang
- Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China (mainland)
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Porter TR, Adolphson M, High RR, Smith LM, Olson J, Erdkamp M, Xie F, O'Leary E, Wong BF, Eifert-Rain S, Hagen ME, Abdelmoneim SS, Mulvagh SL. Rapid Detection of Coronary Artery Stenoses With Real-Time Perfusion Echocardiography During Regadenoson Stress. Circ Cardiovasc Imaging 2011; 4:628-35. [DOI: 10.1161/circimaging.111.966341] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background—
Real-time myocardial contrast echocardiography permits the detection of myocardial perfusion abnormalities during stress echocardiography, which may improve the accuracy of the test in detecting coronary artery stenoses. We hypothesized that this technique could be used after a bolus injection of the selective A2A receptor agonist regadenoson to rapidly and safely detect coronary artery stenoses.
Methods and Results—
In 100 patients referred for quantitative coronary angiography, real-time myocardial contrast echocardiography was performed during a continuous intravenous infusion of 3% Definity at baseline and at 2-minute intervals for up to 6 minutes after a regadenoson bolus injection (400 μg). Myocardial perfusion was assessed by examination of myocardial contrast replenishment after brief high mechanical index impulses. A perfusion defect was defined as a delay (>2 seconds) in myocardial contrast replenishment in 2 contiguous segments. Wall motion was also analyzed. The overall sensitivity/specificity/accuracy for myocardial perfusion analysis in detecting a >50% diameter stenosis was 80%/74%/78%, whereas for wall motion analysis it was 60%/72%/66% (
P
<0.001 for differences in sensitivity). Sensitivity for myocardial perfusion analysis was highest on images obtained during the first 2 minutes after regadenoson bolus (
P
<0.001 compared with wall motion), whereas wall motion sensitivity was highest at the 4-to-6–minute period after the bolus. No significant side effects occurred after regadenoson bolus injection.
Conclusions—
Regadenoson real-time myocardial contrast echocardiography appears to be a feasible, safe, and rapid noninvasive method for the detection of significant coronary artery stenoses.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT0087369.
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Affiliation(s)
- Thomas R. Porter
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
| | - Mary Adolphson
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
| | - Robin R. High
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
| | - Lynette M. Smith
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
| | - Joan Olson
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
| | - Michelle Erdkamp
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
| | - Feng Xie
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
| | - Edward O'Leary
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
| | - Benjamin F. Wong
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
| | - Susan Eifert-Rain
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
| | - Mary E. Hagen
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
| | - Sahar S. Abdelmoneim
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
| | - Sharon L. Mulvagh
- From the University of Nebraska Medical Center (T.R.P., M.A., R.R.H., L.M.S., J.O., M.E., F.X., E.O.), Omaha, NE, and Mayo Clinic and College of Medicine (B.F.W., S.E.-R., M.E.E., S.S.A., S.L.M.), Rochester, MN
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