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

研究成果: Article査読

18 被引用数 (Scopus)

抄録

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.

本文言語English
ページ(範囲)1329-1333
ページ数5
ジャーナルAmerican Journal of Cardiology
79
10
DOI
出版ステータスPublished - 1997 5月 15
外部発表はい

ASJC Scopus subject areas

  • 循環器および心血管医学

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