Myocardial contrast produced with intermittent harmonic imaging combined with wall thickening during low dose dobutamine can identify when a significant residual stenosis is present in viable myocardium following reperfusion in acute myocardial infarction

Thomas Richard Porter, Shouping Li, Karen Kilzer, Kay Talibitzer, Ubeydullah Deligonul

Research output: Contribution to journalArticle

Abstract

The myocardial contrast (MC) produced with intermittent harmonic imaging (IHI) following intravenous injections (IVI) of perfluorocarbon-exposed sonicated dextrose albumin (PESDA) may be an indicator of microvascular integrity following coronary reperfusion (Cor Rep) in acute myocardial infarction. The MC seen with IHI may also be affected by a significant residual stenosis (RS) after Cor Rep. Although wall thickening (WT) may improve during low dose dobutamine (LDD) in viable myocardium (VM) even if a RS is present, we hypothesized that MC intensity with IHI following IV PESDA would be abnormal, and thus differentiate jeopardized VM from VM without a RS. Accordingly, four different scenarios were created following prolonged coronary occlusion (2.1 ± 0.6 hours) in 25 dogs after Cor Rep: (1) transmural infarction (TMI) with no RS (Inf-NS) ; (2) TMI with a significant (>50% diameter) RS (Inf-S); (3) no or partial infarction with no RS (PI-NS); and (4) no or partial infarction with a significant RS (PI-S). The peak myocardial videointensily (PMVD ratio (repertused zone/normal zone) following 0.005-0.01 ml/kg IVI of PESDA and percent %WT in the reperfused zone were measured during LDD: Inf-NS Inf-S PI-NS PI-S PMVI ratio 0.55 ± 0.8 0.34 ± 0.3 0.9 ± 0.3*0.43 ± 0.13 %WT 20 ±15 18 ±14 37 ± 9 a 34 ± 10 a*p<0.05 compared to other groups; a p<0.05 compared to Inf groups. The sensitivity and specificity of a PMVI ratio <0.6 combined with WT>25% during LDD for identifying jeopardized VM was 86 and 94%, while a PMVI ratio >0.6 and WT>25% had a 100% sensitivity and 97% specified for identifying VM without a RS. PMVI obtained with IHI combined with WT responses during LDD can differentiate viable but ischemic from viable non-ischemic myocardium following Cor Rep hi acute myocardial infarction.

Original languageEnglish (US)
Number of pages1
JournalJournal of the American Society of Echocardiography
Volume10
Issue number4
StatePublished - Dec 1 1997

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Dobutamine
Reperfusion
Myocardium
Pathologic Constriction
Myocardial Infarction
Myocardial Reperfusion
Fluorocarbons
Infarction
Albumins
Glucose
Intravenous Injections
Coronary Occlusion
Dogs

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{096b79b2983d4251bae58f6ca463d15c,
title = "Myocardial contrast produced with intermittent harmonic imaging combined with wall thickening during low dose dobutamine can identify when a significant residual stenosis is present in viable myocardium following reperfusion in acute myocardial infarction",
abstract = "The myocardial contrast (MC) produced with intermittent harmonic imaging (IHI) following intravenous injections (IVI) of perfluorocarbon-exposed sonicated dextrose albumin (PESDA) may be an indicator of microvascular integrity following coronary reperfusion (Cor Rep) in acute myocardial infarction. The MC seen with IHI may also be affected by a significant residual stenosis (RS) after Cor Rep. Although wall thickening (WT) may improve during low dose dobutamine (LDD) in viable myocardium (VM) even if a RS is present, we hypothesized that MC intensity with IHI following IV PESDA would be abnormal, and thus differentiate jeopardized VM from VM without a RS. Accordingly, four different scenarios were created following prolonged coronary occlusion (2.1 ± 0.6 hours) in 25 dogs after Cor Rep: (1) transmural infarction (TMI) with no RS (Inf-NS) ; (2) TMI with a significant (>50{\%} diameter) RS (Inf-S); (3) no or partial infarction with no RS (PI-NS); and (4) no or partial infarction with a significant RS (PI-S). The peak myocardial videointensily (PMVD ratio (repertused zone/normal zone) following 0.005-0.01 ml/kg IVI of PESDA and percent {\%}WT in the reperfused zone were measured during LDD: Inf-NS Inf-S PI-NS PI-S PMVI ratio 0.55 ± 0.8 0.34 ± 0.3 0.9 ± 0.3*0.43 ± 0.13 {\%}WT 20 ±15 18 ±14 37 ± 9 a 34 ± 10 a*p<0.05 compared to other groups; a p<0.05 compared to Inf groups. The sensitivity and specificity of a PMVI ratio <0.6 combined with WT>25{\%} during LDD for identifying jeopardized VM was 86 and 94{\%}, while a PMVI ratio >0.6 and WT>25{\%} had a 100{\%} sensitivity and 97{\%} specified for identifying VM without a RS. PMVI obtained with IHI combined with WT responses during LDD can differentiate viable but ischemic from viable non-ischemic myocardium following Cor Rep hi acute myocardial infarction.",
author = "Porter, {Thomas Richard} and Shouping Li and Karen Kilzer and Kay Talibitzer and Ubeydullah Deligonul",
year = "1997",
month = "12",
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language = "English (US)",
volume = "10",
journal = "Journal of the American Society of Echocardiography",
issn = "0894-7317",
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TY - JOUR

T1 - Myocardial contrast produced with intermittent harmonic imaging combined with wall thickening during low dose dobutamine can identify when a significant residual stenosis is present in viable myocardium following reperfusion in acute myocardial infarction

AU - Porter, Thomas Richard

AU - Li, Shouping

AU - Kilzer, Karen

AU - Talibitzer, Kay

AU - Deligonul, Ubeydullah

PY - 1997/12/1

Y1 - 1997/12/1

N2 - The myocardial contrast (MC) produced with intermittent harmonic imaging (IHI) following intravenous injections (IVI) of perfluorocarbon-exposed sonicated dextrose albumin (PESDA) may be an indicator of microvascular integrity following coronary reperfusion (Cor Rep) in acute myocardial infarction. The MC seen with IHI may also be affected by a significant residual stenosis (RS) after Cor Rep. Although wall thickening (WT) may improve during low dose dobutamine (LDD) in viable myocardium (VM) even if a RS is present, we hypothesized that MC intensity with IHI following IV PESDA would be abnormal, and thus differentiate jeopardized VM from VM without a RS. Accordingly, four different scenarios were created following prolonged coronary occlusion (2.1 ± 0.6 hours) in 25 dogs after Cor Rep: (1) transmural infarction (TMI) with no RS (Inf-NS) ; (2) TMI with a significant (>50% diameter) RS (Inf-S); (3) no or partial infarction with no RS (PI-NS); and (4) no or partial infarction with a significant RS (PI-S). The peak myocardial videointensily (PMVD ratio (repertused zone/normal zone) following 0.005-0.01 ml/kg IVI of PESDA and percent %WT in the reperfused zone were measured during LDD: Inf-NS Inf-S PI-NS PI-S PMVI ratio 0.55 ± 0.8 0.34 ± 0.3 0.9 ± 0.3*0.43 ± 0.13 %WT 20 ±15 18 ±14 37 ± 9 a 34 ± 10 a*p<0.05 compared to other groups; a p<0.05 compared to Inf groups. The sensitivity and specificity of a PMVI ratio <0.6 combined with WT>25% during LDD for identifying jeopardized VM was 86 and 94%, while a PMVI ratio >0.6 and WT>25% had a 100% sensitivity and 97% specified for identifying VM without a RS. PMVI obtained with IHI combined with WT responses during LDD can differentiate viable but ischemic from viable non-ischemic myocardium following Cor Rep hi acute myocardial infarction.

AB - The myocardial contrast (MC) produced with intermittent harmonic imaging (IHI) following intravenous injections (IVI) of perfluorocarbon-exposed sonicated dextrose albumin (PESDA) may be an indicator of microvascular integrity following coronary reperfusion (Cor Rep) in acute myocardial infarction. The MC seen with IHI may also be affected by a significant residual stenosis (RS) after Cor Rep. Although wall thickening (WT) may improve during low dose dobutamine (LDD) in viable myocardium (VM) even if a RS is present, we hypothesized that MC intensity with IHI following IV PESDA would be abnormal, and thus differentiate jeopardized VM from VM without a RS. Accordingly, four different scenarios were created following prolonged coronary occlusion (2.1 ± 0.6 hours) in 25 dogs after Cor Rep: (1) transmural infarction (TMI) with no RS (Inf-NS) ; (2) TMI with a significant (>50% diameter) RS (Inf-S); (3) no or partial infarction with no RS (PI-NS); and (4) no or partial infarction with a significant RS (PI-S). The peak myocardial videointensily (PMVD ratio (repertused zone/normal zone) following 0.005-0.01 ml/kg IVI of PESDA and percent %WT in the reperfused zone were measured during LDD: Inf-NS Inf-S PI-NS PI-S PMVI ratio 0.55 ± 0.8 0.34 ± 0.3 0.9 ± 0.3*0.43 ± 0.13 %WT 20 ±15 18 ±14 37 ± 9 a 34 ± 10 a*p<0.05 compared to other groups; a p<0.05 compared to Inf groups. The sensitivity and specificity of a PMVI ratio <0.6 combined with WT>25% during LDD for identifying jeopardized VM was 86 and 94%, while a PMVI ratio >0.6 and WT>25% had a 100% sensitivity and 97% specified for identifying VM without a RS. PMVI obtained with IHI combined with WT responses during LDD can differentiate viable but ischemic from viable non-ischemic myocardium following Cor Rep hi acute myocardial infarction.

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