Quantitative 3-Dimensional Contrast Echocardiographic Determination of Myocardial Mass at Risk and Residual Infarct Mass After Reperfusion: Experimental Canine Studies with Intravenous Contrast Agent NC100100

Abstract

Two-dimensional contrast echocardiography has been shown to enable the evaluation of myocardial perfusion abnormalities. However, its ability to quantify a regional myocardial mass is limited. The goal of this study was to examine the quantitative value of 3-dimensional echocardiography (3DE) in the estimation of myocardial mass at risk, salvaged mass, and residual infarct mass after intravenous injection of contrast. We created acute coronary occlusion, followed by reperfusion in 10 dogs. Three-dimensional echocardiographic data were acquired at the end of each stage, and the perfusion defect mass and dysfunctional mass were measured. The true mass at risk and infarct mass were determined by anatomic methods. The anatomic mass at risk (x) (27.1 ± 14.6 g or 23.8% ± 9.7% of the left ventricle [%LV]) correlated well with the 3DE–determined perfusion defect mass (y) during coronary occlusion (y = 0.5x + 8.9; r = 0.90; P <.001; mean difference –4.8 ± 8.1 g; or y = 0.7x + 6.5; r = 0.83, P <.01; mean difference –0.1 ± 5.4 %LV). Good correlation was also found between the anatomic infarct mass (x) (9.3 ± 8.1 g or 9.1 ± 8.8 %LV) and the 3DE perfusion defect mass after reperfusion (y) (y = 1.2x + 1.2; r = 0.93; P <.001; mean difference 2.3 ± 4.0 g; or y = 1.3x, r = 0.98, P <.0001; mean difference 2.7 ± 3.7 %LV). The salvaged mass was 13.6 ± 11.0 %LV from anatomic methods and 14.2 ± 13.0 %LV by 3DE. To conclude, with the use of intravenous contrast, 3DE could quantify the actual mass at risk during acute ischemia, and in the setting of reperfusion, the residual infarct mass and salvaged mass. (J Am Soc Echocardiogr 2000;13:570-81.)