Basic Research in Cardiology

, Volume 96, Issue 4, pp 415–421

Differential value of adenosine myocardial contrast echocardiography and dobutamine stress echocardiography in evaluating functional significance of coronary artery stenosis in a porcine model

Authors

  • Stefan E. Hardt
    • Department of Cardiology, University of Heidelberg, Bergheimer Str. 58, 69115 Heidelberg, Germany E-mail: Helmut_Kuecherer@med.uni-heidelberg.de
  • Isabell Pekrul
    • Department of Cardiology, University of Heidelberg, Bergheimer Str. 58, 69115 Heidelberg, Germany E-mail: Helmut_Kuecherer@med.uni-heidelberg.de
  • Alexander Hansen
    • Department of Cardiology, University of Heidelberg, Bergheimer Str. 58, 69115 Heidelberg, Germany E-mail: Helmut_Kuecherer@med.uni-heidelberg.de
  • Martha M. Gebhard
    • Department of Experimental Surgery, University of Heidelberg, INF 365, 69120 Heidelberg, Germany
  • Wolfgang Kuebler
    • Department of Cardiology, University of Heidelberg, Bergheimer Str. 58, 69115 Heidelberg, Germany E-mail: Helmut_Kuecherer@med.uni-heidelberg.de
  • Helmut F. Kuecherer
    • Department of Cardiology, University of Heidelberg, Bergheimer Str. 58, 69115 Heidelberg, Germany E-mail: Helmut_Kuecherer@med.uni-heidelberg.de
Original Contribution

DOI: 10.1007/s003950170050

Cite this article as:
Hardt, S., Pekrul, I., Hansen, A. et al. Basic Res Cardiol (2001) 96: 415. doi:10.1007/s003950170050

Abstract

Aim Myocardial contrast echocardiography (MCE) during adenosine induced hyperemia is an experimental method that detects flow limiting coronary artery stenosis by visualizing myocardial perfusion defects. Noninvasive detection of flow limiting coronary artery stenosis in clinical routine is a frequent domaine of dobutamine stress echocardiography (DSE) visualizing ischemia related regional wall motion abnormalities. This study investigated the values of adenosine MCE and DSE in the detection of functionally significant coronary artery stenosis in an experimental open chest pig model. Methods A total of 28 proximal LAD stenoses were instrumented in 12 animals. Reduction of coronary blood flow reserve (Δ CFR [%]) was calculated as a marker of functional significance of coronary artery stenosis (mild to moderate stenosis: Δ CRF ≤ 50%; severe stenosis: Δ CFR > 50%). Fractional area shortening (FAS) and wall thickening (WT) were calculated to evaluate regional wall motion. Peak myocardial contrast intensities (PCI) were measured following aortic root injections of Levovist' to detect myocardial perfusion defects. Results As a group, severe stenosis significantly reduced wall motion response to dobutamine (Δ FAS: 12.0 ± 3.0%, vs. 20 ± 3.0% without stenosis, p < 0.05; Δ WT: 2.2 ± 0.9 mm vs. 0.0 ± 0.8 mm without stenosis, p < 0.05) and diminished myocardial opacification during hyperemia (PCI: 59 ± 8 units vs. 143 ± 16 units without stenosis, p < 0.05). Mild to moderate stenosis did not influence wall motion but reduced myocardial opacification (PCI 89 ± 14 units vs. 143 ± 16 units). PCI correlated more closely with alterations in CFR (r = −0.7, p < 0.0001) than did FAS (r = −0.5, p < 0.002) or WT (r = −0.2, p = 0.3). Conclusion Adenosine myocardial contrast echocardiography detects flow limiting coronary artery stenosis and compares favorably to regional wall motion analysis during dobutamine infusion.

Key words Experimental coronary artery stenosis – myocardial ischemia – myocardial contrast echocardiography – dobutamine stress echocardiography

Copyright information

© Steinkopff Verlag 2001