Assessment of location and size of myocardial infarction with contrast-enhanced echocardiography

W. F. Armstrong, S. R. West, T. M. Mueller, J. C. Dillon, Harvey Feigenbaum

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Abstract

The ability of contrast-enhanced echocardiography to localize and quantify myocardial infarction was studied in 16 open chest dogs. Both routine and contrast-enhanced two-dimensional echocardiograms were recorded at baseline and 4 hours after occlusion of the left anterior descending (n = 11) or circumflex (n = 5) coronary artery. Ultrasound contrast was produced by injection into the aortic root of 3 ml of 0.3% hydrogen peroxide mixed with 6 ml blood. Systolic wall thickening was also measured and quantified as a marker of myocardial infarction. Dogs were sacrificed after 4 hours of coronary occlusion. The slice of the left ventricle that corresponded to the two-dimensional echocardiogram was stained with nitro-blue tetrazolium to localize the infarct. The size of the myocardial infarct was determined by planimetry. The oxygen bubbles produced by mixing hydrogen peroxide with blood produced an excellent intramyocardial ultrasound contrast effect. Complete data were available in 12 dogs. Contrast echocardiography accurately localized the infarction in all 11 dogs with an infarct documented by nitro-blue tetrazolium. The area of the infarct, determined by planimetry and expressed as a fraction of total myocardial area from the nitro-blue tetrazolium study, correlated well with the size of the infarct determined with contrast echocardiography (correlation coefficient [r] = 0.92, standard error of the estimate [SEE] = 0.05, probability [p] <0.001). Intra- and interobserver correlations were excellent for the determination of fraction of infarcted myocardium by contrast echocardiography (r = 0.93, p <0.001, SEE = 0.04; r = 0.89, p <0.001, SEE = 0.07, respectively). Absence of systolic wall thickening also accurately localized myocardial infarction, but correlated poorly with the extent of infarction (r = 0.29, p = not significant). It is concluded that contrast-enhanced two-dimensional echocardiography, using a combination of hydrogen peroxide and blood to provide ultrasound contrast, accurately and reproducibly localizes and quantifies myocardial infarction.

Original languageEnglish (US)
Pages (from-to)63-69
Number of pages7
JournalJournal of the American College of Cardiology
Volume2
Issue number1
DOIs
StatePublished - 1983

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Echocardiography
Myocardial Infarction
Dogs
Hydrogen Peroxide
Infarction
Coronary Occlusion
Heart Ventricles
Coronary Vessels
Myocardium
Thorax
Oxygen
Injections
4-anisyltetrazolium blue

ASJC Scopus subject areas

  • Nursing(all)

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Assessment of location and size of myocardial infarction with contrast-enhanced echocardiography. / Armstrong, W. F.; West, S. R.; Mueller, T. M.; Dillon, J. C.; Feigenbaum, Harvey.

In: Journal of the American College of Cardiology, Vol. 2, No. 1, 1983, p. 63-69.

Research output: Contribution to journalArticle

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abstract = "The ability of contrast-enhanced echocardiography to localize and quantify myocardial infarction was studied in 16 open chest dogs. Both routine and contrast-enhanced two-dimensional echocardiograms were recorded at baseline and 4 hours after occlusion of the left anterior descending (n = 11) or circumflex (n = 5) coronary artery. Ultrasound contrast was produced by injection into the aortic root of 3 ml of 0.3{\%} hydrogen peroxide mixed with 6 ml blood. Systolic wall thickening was also measured and quantified as a marker of myocardial infarction. Dogs were sacrificed after 4 hours of coronary occlusion. The slice of the left ventricle that corresponded to the two-dimensional echocardiogram was stained with nitro-blue tetrazolium to localize the infarct. The size of the myocardial infarct was determined by planimetry. The oxygen bubbles produced by mixing hydrogen peroxide with blood produced an excellent intramyocardial ultrasound contrast effect. Complete data were available in 12 dogs. Contrast echocardiography accurately localized the infarction in all 11 dogs with an infarct documented by nitro-blue tetrazolium. The area of the infarct, determined by planimetry and expressed as a fraction of total myocardial area from the nitro-blue tetrazolium study, correlated well with the size of the infarct determined with contrast echocardiography (correlation coefficient [r] = 0.92, standard error of the estimate [SEE] = 0.05, probability [p] <0.001). Intra- and interobserver correlations were excellent for the determination of fraction of infarcted myocardium by contrast echocardiography (r = 0.93, p <0.001, SEE = 0.04; r = 0.89, p <0.001, SEE = 0.07, respectively). Absence of systolic wall thickening also accurately localized myocardial infarction, but correlated poorly with the extent of infarction (r = 0.29, p = not significant). It is concluded that contrast-enhanced two-dimensional echocardiography, using a combination of hydrogen peroxide and blood to provide ultrasound contrast, accurately and reproducibly localizes and quantifies myocardial infarction.",
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