Author + information
- Received October 9, 1989
- Revision received June 21, 1990
- Accepted July 2, 1990
- Published online December 1, 1990.
- Janine R. Shapiro, MD,
- Shimon A. Reisner, MD,
- Gerson S. Lichtenberg, RDCS and
- Richard S. Meltzer, MD, PhD, FACC∗
- ↵∗Address for reprints: Richard S. Meltzer, MD, PhD, Cardiology, Box 679, University of Rochester Medical Center, Rochester, New York 14642.
The transmission of echocardiographic contrast medium and the cyclic changes in left ventricular videodensity during transpulmonary contrast echocardiography were investigated in nine adult volunteers with the use of intravenous injections of sonicated albumin (microbubble size 5.2 ± 2.6 μm). Right and left ventricular and myocardial contrast were quantitated by videodensitometric analysis.
The injections caused no symptoms, and no hemodynamic or electrocardiographic changes were observed. All injections resulted in right ventricular contrast. Mean peak right ventricular videodensity was 75 ± 48 at end-diastole and 61 ± 36 gray scale U/pixel at end-systole (p < 0.05). Seventy-eight percent of injections resulted in left ventricular contrast with a mean peak videodensity of 21 ± 33 gray scale U/pixel. Early systole was associated with a rapid decrease in left ventricular contrast intensity with near total disappearance of contrast by end-systole (from 23 ± 33 and 17 ± 23 U/pixel at end-diastole to 6 ± 10 and 3 ± 2 at end-systole at the left ventricular base and apex, respectively; p < 0.05). None of the injections resulted in myocardial contrast enhancement by visual or quantitative analysis.
Thus, left ventricular contrast echocardiography can be achieved after intravenous injections of sonicated albumin. Transpulmonary left ventricular contrast echocardiography is associated with near total disappearance of contrast during systole. This may be secondary to the destruction of microbubbles by the high left ventricular systolic pressure. These findings may help explain the limited success of this technique thus far for myocardial perfusion imaging.
☆ This work was supported in part by Grant PHS S7RR05403-26 from the National Institutes of Health, Bethesda, Maryland and by a grant from the New York State Science and Technology Foundation, Albany, New York.
- Received October 9, 1989.
- Revision received June 21, 1990.
- Accepted July 2, 1990.