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Cardiovascular Research 1998 40(2):314-321; doi:10.1016/S0008-6363(98)00178-3
© 1998 by European Society of Cardiology
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Copyright © 1998, European Society of Cardiology

Visualization and quantification of myocardial mass at risk using three-dimensional contrast echocardiography1

Jaroslaw D. Kasprzaka, Wim B. Vletterb,c, Jos R.T.C. Roelandtb,c, Jan R. van Meegenb,c, Richard Johnsond and Folkert J. Ten Cateb,c,*

aMedical University of Lódz, Lódz, Poland
bThoraxcentre, University Hospital Rotterdam—Dijkzigt, Rotterdam, The Netherlands
cErasmus University, Rotterdam, The Netherlands
dAndaris Ltd., Nottingham, UK

* Corresponding author. Tel.: +31-10-463-3986; Fax: +31-10-436-2995; E-mail: F.ten.Cate@zuiderziekenhuis.nl

Objective: Three-dimensional echocardiographic assessment of myocardial ischemia using contrast echocardiography has been hampered by limitations of available contrast agents and analytic software. In the study presented, a three-dimensional perfusion imaging method was evaluated in the porcine model of myocardial ischemia using a novel contrast agent. Methods: Three-dimensional echocardiography was performed in eight open-chested pigs before, during and after left anterior descending (six animals) or circumflex (two animals) coronary artery occlusion. The intramyocardial contrast effect was obtained by left atrial injection of MyomapTM, a deposit contrast agent. Results: Myocardial opacification was visible in all studies and retained in all three-dimensional datasets. Three-dimensional intensity analysis demonstrated a significant difference, exceeding 20 intensity units in every animal (in 127-level scale), between perfused and non-perfused myocardium. Reperfusion followed by contrast reinjection resulted in homogenous myocardial enhancement. Myocardial mass at risk was clearly delineated in all studies and measured with a mean error of –0.1±2.0 g against real mass (p=non-significant). Spatial extent of ischemia could be displayed in volume-rendered reconstruction of separate perfusion territories. Conclusions: Quantitative analysis of myocardial contrast enhancement from three-dimensional datasets is feasible and allows accurate measurement of myocardial mass at risk.

KEYWORDS Ischemia; Ultrasound; Three-dimensional reconstruction; Porcine; Contrast media; Regional blood flow; Ischemic mass quantification

1 Data were presented in part at XVII Congress of ESC, Amsterdam 1995 and 68th AHA Scientific Sessions, Anaheim 1995.


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