937-4 Combined Use of Dobutamine Stress Echocardiography and Myocardial Contrast Echocardiography

Abstract

Combined use of Dobutamine stress Echocardiography (DSE) and Myocardial contrast echocardiography (MCE) offers the unique possibility to study myocardial function and perfusion. To define the characteristics of collateralized myocardium (CM) in comparison to normally perfused myocardium (NM) using DSE and MCE. In 14 patients (pts) (10 males, 4 females) with single vessel total occlusion of one major epicardial coronary artery and intercoronary collaterals (Rentrop3) DSE was performed together with MCE. Wall motion score index (WMSI) was calculated. Sonicated iopamidol was injected into the right and left coronary artery with simultaneous twodimensional Echo imaging of all standard apical views in every patient. Videodensitornetry of contrast enhanced (C) images was used to calculate Intensity (I) increase in gray scale units (U), The same myocardial segments were analyzed to define WMS and U for CM and NM for the presence (+) or absence (-) of wall motion abnormalities. CM NM + - WMSI rest 2.1 ± 0.39 1 ± 0.1 * 1.10 ± 0.09 * stress 2.5 ± 0.61 1.42 ± 0.75 ** 1.19±0.48 MCE (1) 21.5 ± 9.4 40.9 ± 17.6 * 48.0 ± 17.6 * * p < 0.05 + vs -, ** p < 0.05 CM vs NM Despite the presence of large intercoronary collaterals CM has decreased myocardial perfusion which becomes worse if wall motion abnormalities are present Combined use of DSE and MCE provides a unique method to define the characteristics of the myocardium by its contractile function and perfusion.