Detection of regional perfusion abnormalities during adenosine stress echocardiography with intravenous perfluorocarbon-exposed sonicated dextrose albumin

• Published in: The American heart journal Vol. 132; no. 1; pp. 41 - 47
• Main Authors: Porter, Thomas R., Kricsfeld, Alan, Deligonul, Ubeydullah, Xie, Feng
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.1996; Elsevier
• Subjects: Adenosine; Animals; Biological and medical sciences; Cardiac Output; Cardiovascular system; Contrast Media; Coronary Angiography; Coronary Circulation; Coronary Disease - pathology; Coronary Disease - physiopathology; Dogs; Echocardiography - methods; Fluorocarbons; Glucose; Heart Rate; Injections, Intravenous; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Myocardial Ischemia - pathology; Myocardial Ischemia - physiopathology; Serum Albumin; Serum Albumin, Human; Stress, Physiological; Ultrasonic investigative techniques; Vasodilator Agents; Ventricular Function, Left; Ventricular Pressure; Sonography; Fissipedia; Regional blood flow; Carnivora; Adenosine; Echocardiography; Intravenous administration; Cardiovascular disease; Myocardial disease; Stress; Vertebrata; Mammalia; Heart disease; Animal; Myocardium; Anomaly; Diagnosis; Dog; Contrast media
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/S0002-8703(96)90388-9

Although perfluorocarbon-exposed sonicated dextrose albumin (PESDA) microbubbles produce myocardial contrast after intravenous injection, it is unknown whether their use can accurately identify myocardial blood-flow abnormalities during stress echocardiography. Accordingly, we compared the background-subtracted peak myocardial videointensity (PMVI) after intravenous injections of PESDA before and during adenosine stress (100 to 140 units/kg/min) in 10 open-chest dogs with angiographically significant left circumflex artery disease. The ratios of PMVI in the ischemic region compared with the adjacent normal left anterior descending perfusion bed were measured, as were wall-thickening and coronary-flow ratios. In the dogs with a >50% diameter stenosis, there was a decrease in PMVI ratio during adenosine stress by >0.20 in 9, whereas wall-thickening ratios decreased in only 5. PMVI in the ischemic zone increased by <1.5 units during adenosine infusion in 8 of 10 dogs, whereas it increased by >1.5 units in 8 of 10 adjacent normal zones. We conclude that regional myocardial-perfusion abnormalities can be detected with intravenous PESDA during adenosine stress echocardiography.