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Detection of Myocardial Perfusion in Multiple Echocardiographic Windows With One Intravenous Injection of Microbubbles Using Transient Response Second Harmonic Imaging

Objectives. The purpose of this study was to prove that transient response harmonic imaging could detect normal and abnormal myocardial perfusion in multiple echocardiographic windows with one intravenous injection of microbubbles in humans. Background. Myocardial ultrasound contrast can be produced...

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Published in:Journal of the American College of Cardiology 1997-03, Vol.29 (4), p.791-799
Main Authors: Porter, Thomas R., Li, Shouping, Kricsfeld, David, Armbruster, Robert W.
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Li, Shouping
Kricsfeld, David
Armbruster, Robert W.
description Objectives. The purpose of this study was to prove that transient response harmonic imaging could detect normal and abnormal myocardial perfusion in multiple echocardiographic windows with one intravenous injection of microbubbles in humans. Background. Myocardial ultrasound contrast can be produced from intravenous perfluorocarbon-exposed sonicated dextrose albumin, and ultrasound can be significantly improved by briefly suspending the interval between frame rates. Whether this contrast can noninvasively quantify myocardial perfusion in humans is unknown. Methods. In 28 patients, harmonic transient response imaging was used to image the heart in multiple different imaging planes after one intravenous injection of ultrasound contrast agent. Twenty-five of these 28 patients had a repeat injection during dipyridamole stress. In the primary view, the ultrasound transmission rate was one frame per cardiac cycle; in secondary and tertiary views, the transmission rate was once every multiple cardiac cycles. Regional myocardial contrast was visually assessed and quantified off-line. Quantitative rest thallium and dipyridamole stress sestamibi imaging was also performed. Results. Perfusion abnormalities were evident in the secondary and tertiary views only with one frame every multiple cardiac cycles. Regional peak myocardial videointensity (PMVI) correlated closely with regional tracer uptake in individual patients both at rest (r = 0.84) and during stress (r = 0.88). A PMVI ratio (abnormal region divided by the region with highest nuclear uptake)
doi_str_mv 10.1016/S0735-1097(96)00575-X
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The purpose of this study was to prove that transient response harmonic imaging could detect normal and abnormal myocardial perfusion in multiple echocardiographic windows with one intravenous injection of microbubbles in humans. Background. Myocardial ultrasound contrast can be produced from intravenous perfluorocarbon-exposed sonicated dextrose albumin, and ultrasound can be significantly improved by briefly suspending the interval between frame rates. Whether this contrast can noninvasively quantify myocardial perfusion in humans is unknown. Methods. In 28 patients, harmonic transient response imaging was used to image the heart in multiple different imaging planes after one intravenous injection of ultrasound contrast agent. Twenty-five of these 28 patients had a repeat injection during dipyridamole stress. In the primary view, the ultrasound transmission rate was one frame per cardiac cycle; in secondary and tertiary views, the transmission rate was once every multiple cardiac cycles. Regional myocardial contrast was visually assessed and quantified off-line. Quantitative rest thallium and dipyridamole stress sestamibi imaging was also performed. Results. Perfusion abnormalities were evident in the secondary and tertiary views only with one frame every multiple cardiac cycles. Regional peak myocardial videointensity (PMVI) correlated closely with regional tracer uptake in individual patients both at rest (r = 0.84) and during stress (r = 0.88). A PMVI ratio (abnormal region divided by the region with highest nuclear uptake) &lt;0.6 in any view had a 92% sensitivity and a 84% specificity in identifying a regional nuclear perfusion abnormality. Conclusions. Transient response imaging produces myocardial contrast in multiple views with one intravenous injection of contrast agent and can accurately identify regional myocardial perfusion abnormalities. (J Am Coll Cardiol 1997;29:791–9)</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/S0735-1097(96)00575-X</identifier><identifier>PMID: 9091526</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cardiovascular system ; Contrast Media ; Dipyridamole ; Echocardiography - methods ; Exercise Test ; Female ; Fluorocarbons ; Heart - diagnostic imaging ; Humans ; Image Enhancement ; Injections, Intravenous ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Observer Variation ; Sonication ; Technetium Tc 99m Sestamibi ; Thallium Radioisotopes ; Tomography, Emission-Computed, Single-Photon ; Ultrasonic investigative techniques ; Vasodilator Agents</subject><ispartof>Journal of the American College of Cardiology, 1997-03, Vol.29 (4), p.791-799</ispartof><rights>1997 The American College of Cardiology</rights><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c402t-b1b172d8221dd32f317eb606cb42ce35441932c4962c37aa4a675a1985ebdc23</citedby><cites>FETCH-LOGICAL-c402t-b1b172d8221dd32f317eb606cb42ce35441932c4962c37aa4a675a1985ebdc23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=2610643$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9091526$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Porter, Thomas R.</creatorcontrib><creatorcontrib>Li, Shouping</creatorcontrib><creatorcontrib>Kricsfeld, David</creatorcontrib><creatorcontrib>Armbruster, Robert W.</creatorcontrib><title>Detection of Myocardial Perfusion in Multiple Echocardiographic Windows With One Intravenous Injection of Microbubbles Using Transient Response Second Harmonic Imaging</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Objectives. The purpose of this study was to prove that transient response harmonic imaging could detect normal and abnormal myocardial perfusion in multiple echocardiographic windows with one intravenous injection of microbubbles in humans. Background. Myocardial ultrasound contrast can be produced from intravenous perfluorocarbon-exposed sonicated dextrose albumin, and ultrasound can be significantly improved by briefly suspending the interval between frame rates. Whether this contrast can noninvasively quantify myocardial perfusion in humans is unknown. Methods. In 28 patients, harmonic transient response imaging was used to image the heart in multiple different imaging planes after one intravenous injection of ultrasound contrast agent. Twenty-five of these 28 patients had a repeat injection during dipyridamole stress. In the primary view, the ultrasound transmission rate was one frame per cardiac cycle; in secondary and tertiary views, the transmission rate was once every multiple cardiac cycles. Regional myocardial contrast was visually assessed and quantified off-line. Quantitative rest thallium and dipyridamole stress sestamibi imaging was also performed. Results. Perfusion abnormalities were evident in the secondary and tertiary views only with one frame every multiple cardiac cycles. Regional peak myocardial videointensity (PMVI) correlated closely with regional tracer uptake in individual patients both at rest (r = 0.84) and during stress (r = 0.88). A PMVI ratio (abnormal region divided by the region with highest nuclear uptake) &lt;0.6 in any view had a 92% sensitivity and a 84% specificity in identifying a regional nuclear perfusion abnormality. Conclusions. Transient response imaging produces myocardial contrast in multiple views with one intravenous injection of contrast agent and can accurately identify regional myocardial perfusion abnormalities. (J Am Coll Cardiol 1997;29:791–9)</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular system</subject><subject>Contrast Media</subject><subject>Dipyridamole</subject><subject>Echocardiography - methods</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Fluorocarbons</subject><subject>Heart - diagnostic imaging</subject><subject>Humans</subject><subject>Image Enhancement</subject><subject>Injections, Intravenous</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Observer Variation</subject><subject>Sonication</subject><subject>Technetium Tc 99m Sestamibi</subject><subject>Thallium Radioisotopes</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Ultrasonic investigative techniques</subject><subject>Vasodilator Agents</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><recordid>eNqFkcFu1DAQhi1EVZbCI1TyASE4BGwnduITQqXQlVoV0UX0Zjn2ZNdVYgc7KeoT8Zp4u6sVt57G8nzz2_P_CJ1S8oESKj7ekLrkBSWyfifFe0J4zYvbZ2hBOW-Kksv6OVockBfoZUp3hBDRUHmMjiWRlDOxQH-_wARmcsHj0OGrh2B0tE73-DvEbk7be-fx1dxPbuwBn5vNjgjrqMeNM_iX8zb8SblOG3ztAS_9FPU9-DCnfL77T9yZGNq5bXtI-Gdyfo1XUfvkwE_4B6Qx-AT4BkzwFl_oOASf9ZeDXmf0FTrqdJ_g9b6eoNXX89XZRXF5_W159vmyMBVhU9HSltbMNoxRa0vWlbSGVhBh2ooZKHlVUVkyU0nBTFlrXWlRc01lw6G1hpUn6O1Odozh9wxpUoNLBvpee8gLqbppZCMrkUG-A_NOKUXo1BjdoOODokRt81GP-ait-UoK9ZiPus1zp_sH5nYAe5jaB5L7b_Z9nYzuu2yQcemAMUGJqMqMfdphkL24dxBVMtlHA9bF7LiywT3xkX-JKbBH</recordid><startdate>19970315</startdate><enddate>19970315</enddate><creator>Porter, Thomas R.</creator><creator>Li, Shouping</creator><creator>Kricsfeld, David</creator><creator>Armbruster, Robert W.</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19970315</creationdate><title>Detection of Myocardial Perfusion in Multiple Echocardiographic Windows With One Intravenous Injection of Microbubbles Using Transient Response Second Harmonic Imaging</title><author>Porter, Thomas R. ; Li, Shouping ; Kricsfeld, David ; Armbruster, Robert W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c402t-b1b172d8221dd32f317eb606cb42ce35441932c4962c37aa4a675a1985ebdc23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular system</topic><topic>Contrast Media</topic><topic>Dipyridamole</topic><topic>Echocardiography - methods</topic><topic>Exercise Test</topic><topic>Female</topic><topic>Fluorocarbons</topic><topic>Heart - diagnostic imaging</topic><topic>Humans</topic><topic>Image Enhancement</topic><topic>Injections, Intravenous</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Observer Variation</topic><topic>Sonication</topic><topic>Technetium Tc 99m Sestamibi</topic><topic>Thallium Radioisotopes</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>Ultrasonic investigative techniques</topic><topic>Vasodilator Agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Porter, Thomas R.</creatorcontrib><creatorcontrib>Li, Shouping</creatorcontrib><creatorcontrib>Kricsfeld, David</creatorcontrib><creatorcontrib>Armbruster, Robert W.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Porter, Thomas R.</au><au>Li, Shouping</au><au>Kricsfeld, David</au><au>Armbruster, Robert W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Detection of Myocardial Perfusion in Multiple Echocardiographic Windows With One Intravenous Injection of Microbubbles Using Transient Response Second Harmonic Imaging</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1997-03-15</date><risdate>1997</risdate><volume>29</volume><issue>4</issue><spage>791</spage><epage>799</epage><pages>791-799</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>Objectives. The purpose of this study was to prove that transient response harmonic imaging could detect normal and abnormal myocardial perfusion in multiple echocardiographic windows with one intravenous injection of microbubbles in humans. Background. Myocardial ultrasound contrast can be produced from intravenous perfluorocarbon-exposed sonicated dextrose albumin, and ultrasound can be significantly improved by briefly suspending the interval between frame rates. Whether this contrast can noninvasively quantify myocardial perfusion in humans is unknown. Methods. In 28 patients, harmonic transient response imaging was used to image the heart in multiple different imaging planes after one intravenous injection of ultrasound contrast agent. Twenty-five of these 28 patients had a repeat injection during dipyridamole stress. In the primary view, the ultrasound transmission rate was one frame per cardiac cycle; in secondary and tertiary views, the transmission rate was once every multiple cardiac cycles. Regional myocardial contrast was visually assessed and quantified off-line. Quantitative rest thallium and dipyridamole stress sestamibi imaging was also performed. Results. Perfusion abnormalities were evident in the secondary and tertiary views only with one frame every multiple cardiac cycles. Regional peak myocardial videointensity (PMVI) correlated closely with regional tracer uptake in individual patients both at rest (r = 0.84) and during stress (r = 0.88). A PMVI ratio (abnormal region divided by the region with highest nuclear uptake) &lt;0.6 in any view had a 92% sensitivity and a 84% specificity in identifying a regional nuclear perfusion abnormality. Conclusions. Transient response imaging produces myocardial contrast in multiple views with one intravenous injection of contrast agent and can accurately identify regional myocardial perfusion abnormalities. (J Am Coll Cardiol 1997;29:791–9)</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>9091526</pmid><doi>10.1016/S0735-1097(96)00575-X</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cardiovascular system
Contrast Media
Dipyridamole
Echocardiography - methods
Exercise Test
Female
Fluorocarbons
Heart - diagnostic imaging
Humans
Image Enhancement
Injections, Intravenous
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Observer Variation
Sonication
Technetium Tc 99m Sestamibi
Thallium Radioisotopes
Tomography, Emission-Computed, Single-Photon
Ultrasonic investigative techniques
Vasodilator Agents
title Detection of Myocardial Perfusion in Multiple Echocardiographic Windows With One Intravenous Injection of Microbubbles Using Transient Response Second Harmonic Imaging
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