Quantitative intravenous myocardial contrast echocardiography predicts recovery of left ventricular function after revascularization in chronic coronary artery disease

Abstract

Background: Quantitative intravenous myocardial contrast echocardiography (MCE) has been shown to measure regional myocardial blood flow velocity noninvasively. Purpose: To determine whether quantitative intravenous MCE could be used clinically to predict functional recovery after revascularization in patients with chronic coronary artery disease. Methods: Twenty-eight patients with chronic stable coronary artery disease and resting regional left ventricular dysfunction were included in this study. The study permits myocardial perfusion analysis by intravenous MCE before revascularization with continuous infusion of Levovist and intermittent ultrasonic exposure. Wall motion assessment by echocardiography at rest was repeated after long-term follow-up period (7 ± 2 months). In dysfunctional segments, we analyzed myocardial perfusion quantitatively by fitting to an exponential function, Y = A(1 − e−βt) to obtain the rate of rise (β) of background-subtracted intensity, which represented myocardial blood flow velocity. Results: Of the 101 revascularized dysfunctional segments, MCE was adequately visualized in 91 (90%) segments, and wall motion was recovered in 45 (49%) segments. The value of β in the recovery segments was significantly higher than that in nonrecovery segments (0.80 ± 0.50 vs 0.39 ± 0.24, P 0.5 predicted recovery of segmental function with a sensitivity of 71%, specificity of 78%. Conclusion: Quantitative intravenous MCE can predict functional recovery after revascularization in patients with chronic coronary artery disease. (ECHOCARDIOGRAPHY, Volume 21, February 2004)