Dataset Information

Resting Myocardial Contrast Echocardiography for the Evaluation of Coronary Microcirculation Dysfunction in Patients With Early Coronary Artery Disease.

ABSTRACT:

Background

Coronary microcirculation dysfunction can occur in patients with chest pain suggestive of coronary artery disease (CAD). The present study aimed to determine the diagnostic value of resting myocardial contrast echocardiography (MCE) for early CAD with myocardial microcirculation dysfunction by evaluating the continuous imaging time, peak time, and peak intensity.

Hypothesis

Resting MCE is an effective and noninvasive method for evaluation of coronary microcirculation dysfunction in patients with early coronary artery disease.

Methods

The present study included 20 consecutive patients without obvious clinical evidence of early CAD and 20 healthy volunteers. Resting MCE was performed to evaluate the myocardial microcirculation perfusion, and the follow-up evaluation of myocardial microcirculation perfusion was performed with technetium 99?m 2-methoxy-isobutyl-isonitrile ((99m) Tc-MIBI) single-photon emission computed tomography (SPECT).

Results

Peak intensity was significantly lower in patients with high risk of CAD than in controls (P < 0.0001). The peak time and continuous imaging time were significantly higher in patients with high risk of CAD than in controls (P < 0.0001). None of the 40 subjects experienced discomfort, such as cough and chest tightness, during the resting MCE procedure, and the heart rate and blood pressure showed no abnormalities during the entire procedure. SPECT imaging showed reversible myocardial perfusion reduction in 80% (16/20) of the patients with high risk of CAD. Abnormalities of heart rate and blood pressure and adverse reactions were noted during the process of SPECT examination.

Conclusions

Resting MCE is an effective and noninvasive method for detecting abnormalities of coronary microcirculation and can help in the clinical analysis, risk assessment, and treatment of early occult CAD.

SUBMITTER: Li X

PROVIDER: S-EPMC6490753 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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Publications

Resting Myocardial Contrast Echocardiography for the Evaluation of Coronary Microcirculation Dysfunction in Patients With Early Coronary Artery Disease.

Li Xin X He Sheng S Zhang Yun-Shan YS Chen Yu Y He Jiang-Chun JC

Clinical cardiology 20160510 8

<h4>Background</h4>Coronary microcirculation dysfunction can occur in patients with chest pain suggestive of coronary artery disease (CAD). The present study aimed to determine the diagnostic value of resting myocardial contrast echocardiography (MCE) for early CAD with myocardial microcirculation dysfunction by evaluating the continuous imaging time, peak time, and peak intensity.<h4>Hypothesis</h4>Resting MCE is an effective and noninvasive method for evaluation of coronary microcirculation dy ...[more]

PMID: 27163691

Similar Datasets

Project description:BackgroundMicrovascular dysfunction (MVD) is a potential cause of chest pain in younger individuals. The authors hypothesized that nonelderly patients referred for computed tomographic angiography (CTA) but without significant stenosis would have a high prevalence of MVD by myocardial contrast echocardiography (MCE). Secondary aims were to test whether the presence of nonobstructive coronary artery disease (CAD) or reduced brachial flow-mediated dilation (FMD) predicted MVD.MethodsSubjects ≤60 years of age undergoing CTA were recruited if they had either no evidence of coronary plaque or evidence of mild CAD (<50% stenosis) and at least one high-risk plaque feature. Subjects underwent quantitative perfusion imaging using MCE at rest and during regadenoson vasodilator stress. MVD was defined as global or segmental delay of microvascular refill (≥2 sec) during regadenoson. FMD of the brachial artery was also performed.ResultsOf the 29 patients in whom MCE could be performed, 12 (41%) had MVD. These subjects, compared with those with normal microvascular function, had lower hyperemic perfusion (mean, 236 ± 68 vs 354 ± 161 intensity units/sec; P = .02) and microvascular flux rate (mean, 1.6 ± 0.4 vs 2.5 ± 0.9 sec-1; P = .002) on quantitative MCE. The degree of FMD was not significantly different in those with or without MVD (mean, 11 ± 4% vs 9 ± 4%; P = .32), and there was a poor correlation between results on stress MCE and FMD. Only eight of the 29 subjects were classified as having nonobstructive CAD. There were no groupwise differences in the prevalence of MVD function in those with versus without CAD (43% vs 38% for negative and positive findings on CTA, respectively, P = .79).ConclusionsMVD is a common finding in the nonelderly population referred for CTA for evaluation of possible CAD but without obstructive stenosis. Neither the presence of noncritical atherosclerotic disease nor abnormal FMD increases the likelihood for detecting MVD in this population.

Dataset Information

Resting Myocardial Contrast Echocardiography for the Evaluation of Coronary Microcirculation Dysfunction in Patients With Early Coronary Artery Disease.

Background

Hypothesis

Methods

Results

Conclusions

Publications

Resting Myocardial Contrast Echocardiography for the Evaluation of Coronary Microcirculation Dysfunction in Patients With Early Coronary Artery Disease.

Similar Datasets

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