Quantification of transmural gradient of blood flow in myocardial ischemia with real-time myocardial contrast echocardiography and dipyridamole stress test.

Quantification of transmural gradient of blood flow in myocardial ischemia with real-time myocardial contrast echocardiography and dipyridamole stress test. Research Abstract Details 

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Quantification of transmural gradient of blood flow in myocardial ischemia with real-time myocardial contrast echocardiography and dipyridamole stress test. Abstract Text:

Gui-Hua Yao,Cheng Zhang,Feng-Rong Sun,Mei Zhang,Yu-Xia Zhao,Peng-Fei Zhang,Lin Zhong,Shi-Fang Ding,Wen-Qiang Chen,Xiao-Nan Li,Yun Zhang,Gui-Hua Yao,Cheng Zhang,Feng-Rong Sun,Mei Zhang,Yu-Xia Zhao,Peng-Fei Zhang,Lin Zhong,Shi-Fang Ding,Wen-Qiang Chen,Xiao-Nan Li,Yun Zhang,

Transmural redistribution of myocardial blood flow (MBF) is the earliest sign of myocardial ischemia. We aimed to evaluate the ability of real-time myocardial contrast echocardiography (MCE) combined with dipyridamole stress to quantify the transmural gradient of MBF during graded coronary stenosis. Real-time MCE was performed in 14 open-chest dogs at seven experimental stages: baseline; hyperemia induced by 6-min infusion of dipyridamole; 50%, 75% and 90% reduction of hyperemic flow after constriction in each stage for 10 min; reperfusion for 10 min; and subtotal occlusion of the left anterior descending coronary artery (LAD) for 90 min. We obtained MCE perfusion parameters from subendocardial (A-endo, beta-endo and A x beta-endo) and subepicardial (A-epi, beta-epi and A x beta-epi) layers of the ventricular septum and calculated their transmural gradients (A-EER, beta-EER and A x beta-EER) and systolic wall thickening (SWT). The sensitivity and specificity of each parameter for predicting 75% reduction of hyperemic flow, which was defined as mild myocardial ischemia, were derived by receiver operating characteristic (ROC) curve analysis. No transmural gradients were found at baseline; during maximal hyperemia and 50% reduction of hyperemic flow. beta-endo, A x beta-endo, beta-EER and A x beta-EER decreased significantly when the hyperemic flow was reduced by 75% or more. In contrast, SWT remained unchanged until the hyperemic flow was reduced by 90%. Among all parameters measured, beta-EER and A x beta-EER had the highest and SWT the lowest sensitivity and specificity in predicting mild myocardial ischemia. In conclusion, real-time MCE combined with dipyridamole stress allows for quantification of the transmural gradient of MBF. beta-EER and A x beta-EER are more sensitive than SWT and other MCE parameters in detecting mild myocardial ischemia. (E-mail: yaogh@yahoo.com; yun-zhang@163.com).

Quantification of transmural gradient of blood flow in myocardial ischemia with real-time myocardial contrast echocardiography and dipyridamole stress test. Publishing Authors By Initials

GH Yao,C Zhang,FR Sun,M Zhang,YX Zhao,PF Zhang,L Zhong,SF Ding,WQ Chen,XN Li,Y Zhang,GH Yao,C Zhang,FR Sun,M Zhang,YX Zhao,PF Zhang,L Zhong,SF Ding,WQ Chen,XN Li,Y Zhang,

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Quantification of transmural gradient of blood flow in myocardial ischemia with real-time myocardial contrast echocardiography and dipyridamole stress test. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Ultrasound in medicine & biology

VOLUME: 34

Page Numbers: 22-30

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ISSN: 0301-5629

DAY: 14

MONTH: 09

YEAR: 2007

Quantification of transmural gradient of blood flow in myocardial ischemia with real-time myocardial contrast echocardiography and dipyridamole stress test. Information

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LANGUAGE: eng

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Grant and Affiliation Information for Quantification of transmural gradient of blood flow in myocardial ischemia with real-time myocardial contrast echocardiography and dipyridamole stress test.

AFFILIATION: The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong, China.

Country: England

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MEDLINETA: Ultrasound Med Biol

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