Comparison of myocardial contrast echocardiography and coronary angiography for assessing the acute protective effects of collateral recruitment during occlusion of the left anterior descending coronary artery at the time of elective angioplasty

Yasuhiko Sakata, Kazuhisa Kodama, Takayoshi Adachi, Young Jae Lim, Fuminobu Ishikura, Hisakazu Fuji, Tohru Masuyama, Atsushi Hirayama

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17 Citations (Scopus)

Abstract

To assess the immediate change in collateral flow distribution within the occluded myocardium and the acute protective effects on myocardial ischemia after coronary occlusion, myocardial contrast echocardiography (MCE) was performed in 15 patients with normal left ventricular function undergoing elective coronary angioplasty of the left anterior descending artery, and the results were compared with those obtained from coronary angiography (CA). The sonicated or nonsonicated contrast material was injected into the right coronary artery before and during coronary occlusion and collaterals were graded on a 4-point scale (none = 0 to good = 3). Development of subjective anginal symptoms, ST-segment shift and wall motion abnormality during coronary occlusion were graded on a 4-point scale (none = 0 to severe = 3). Both MCE and CA detected a significant development in collateral flow during coronary occlusion. There was no significant correlation between MCE and CA collateral grades before or during coronary occlusion. The collateral flow assessed with MCE was inversely but significantly correlated with development of subjective anginal symptoms (r, = -0.70, p <0.01), ST-segment shift (r(s) = -0.78, p <0.005) or wall motion abnormality (r(s) = -0.91, p <0.001) during coronary occlusion. In contrast, the angiographic collateral flow was not correlated with development of anginal symptoms (r(s) = -0.46, p = 0.10), ST- segment shift (r(s) = -0.41, p = 0.14), or wall motion abnormality (r(s) = - 0.26, p = 0.35). The present study suggested that the acute protective effects of coronary collaterals during coronary occlusion were closely associated with myocardial perfusion rather than the angiographic epicardial collateral vessel filling, and thus MCE was useful in assessing the acute protective effects of coronary collaterals during coronary occlusion.

Original languageEnglish
Pages (from-to)1329-1333
Number of pages5
JournalAmerican Journal of Cardiology
Volume79
Issue number10
DOIs
Publication statusPublished - 1997 May 15
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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