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首页> 外文期刊>Ultrasound in Medicine and Biology >Quantification of transmural gradient of blood flow in myocardial ischemia with real-time myocardial contrast echocardiography and dipyridamole stress test.
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Quantification of transmural gradient of blood flow in myocardial ischemia with real-time myocardial contrast echocardiography and dipyridamole stress test.

机译：实时心肌对比超声心动图和双嘧达莫应力测试定量心肌缺血中血流的透壁梯度。

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摘要

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.
机译：心肌血流的透壁再分布（MBF）是心肌缺血的最早迹象。我们旨在评估实时心肌对比超声心动图（MCE）结合双嘧达莫应力量化分级冠状动脉狭窄期间MBF透壁梯度的能力。在七个实验阶段中，对14只开胸的狗进行了实时MCE：基线;输注双嘧达莫6分钟引起的充血;每次收缩10分钟后，充血流量分别减少50％，75％和90％;再灌注10分钟;和左前降支冠状动脉（LAD）的小计阻塞90分钟。我们从心室间隔的心内膜下（A-endo，β-endo和A xβ-endo）和心外膜下（A-epi，β-epi和A xβ-epi）层获得了MCE灌注参数，并计算了它们的透壁梯度（ A-EER，β-EER和A xβ-EER）和收缩期壁增厚（SWT）。通过受试者工作特征（ROC）曲线分析得出了用于预测充血流量减少75％（定义为轻度心肌缺血）的每个参数的敏感性和特异性。在基线处未发现透壁梯度。最大充血和充血流量减少50％期间。当充血流量减少75％或更多时，β-内毒素，A xβ-内毒素，β-EER和A xβ-EER显着下降。相反，SWT保持不变，直到充血流量减少90％。在测量的所有参数中，β-EER和Axβ-EER在预测轻度心肌缺血方面具有最高的敏感性和特异性，而SWT的敏感性和特异性最低。总之，实时MCE与双嘧达莫应力相结合，可以量化MBF的透壁梯度。在检测轻度心肌缺血方面，β-EER和Axβ-EER比SWT和其他MCE参数更敏感。

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