Study of coronary flow reserve with intravenous use of microbubbles (contrast echocardiography) and adenosine: protocol for clinical application in patients suspected of having coronary heart disease.
| Autor: | Morcerf F; Serviço de Ecocardiografia, Hospital Pró-Cardíaco, Centro de Diagnostico Cardiovascular, Rio de Janeiro, Brazil. fmorcerf@cardiol.br, Moraes A, Carrinho M, Dohmann HJ |
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| Jazyk: | English; Portuguese |
| Zdroj: | Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2002 Mar; Vol. 78 (3), pp. 281-98. |
| DOI: | 10.1590/s0066-782x2002000300004 |
| Abstrakt: | Objective: To test the feasibility, safety and accuracy of the adenosine protocol in the study of myocardial perfusion with microbubbles contrast echocardiography. Methods: 81 pts (64 male, 60+11 years) were submitted to contrast echocardiography with PESDA (sonicated solution of albumin 20%-1ml, dextrose 5%-12ml and deca-fluorobutane gas-8ml) to study the myocardial perfusion at rest and after bolus injection of adenosine (6 to 18mg) and to coronary angiography within 1 month each other. For each patient 3 left ventricle perfusion beds were considered (total of 243 territories). 208 territories were analyzed and 35 territories were excluded. PESDA was continuously infused (1-2ml/min), titrated for best myocardial contrast. Triggered (1:1) second harmonic imaging was used. Results: Coronary angiography showed 70 flow limiting (> 75%) lesions and 138 no flow limiting lesions. At rest an obvious myocardium contrast enhancement was seen in at least 1 segment of a territory in all patients. After adenosine injection an unquestionable further increase in myocardial contrast was observed in 136 territories (99%) related to no flow limiting lesions, lasting < 10 s, and a myocardial perfusion defect was detected in 68 territories (97%) related to flow limiting lesions. It was observed only 4 false results. There were no serious complications. Conclusion: Myocardial perfusion study with PESDA and adenosine protocol is a practical, safe and accurate method to analyze the coronary flow reserve. |
| Databáze: | MEDLINE |
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