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European Journal of Echocardiography 2004 5(4):272-283; doi:10.1016/j.euje.2003.10.002
© 2004 by European Society of Cardiology
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Copyright © 2003, The European Society of Cardiology

Estimation of vasodilator response by analysis of Doppler intensity kinetics with myocardial contrast echocardiography using an intravenous standardized bolus administration

A Hagendorffa,*, A Wernera, D Pfeiffera and H Becherb

aDepartment of Cardiology-Angiology, University of Leipzig, Johannisallee 32, 04103 Leipzig, Germany
bDepartment of Cardiology, University of Oxford, Oxford, UK

Received 21 June 2003; received in revised form 6 October 2003; accepted after revision 9 October 2003.

hagea{at}medizin.uni-leipzig.de

* Corresponding author. Tel.: +49-341-97-12650; fax: +49-341-97-12659.


  Abstract

Hypothesis: Myocardial perfusion can be analyzed by the first pass of Doppler intensity (DI) signals in the myocardium by myocardial contrast echocardiography with triggered power Doppler harmonic imaging (PDHI).

Methods and results: DI versus time plots during 1:1 triggering was acquired during a mechanically standardized intravenous bolus application of Levovist (400 mg ml–1; 3 ml min–1) at rest and during vasodilator stress with dipyridamole. Data were analyzed in 21 patients (pts) with normal coronary arteries and in 6 pts with left anterior descending artery (LAD) stenosis. Transthoracic distal LAD-flow velocities could be determined in 7 normal pts. At stress the DI wash-in rate and the DI plateau increased (3.14±0.3 versus 5.06 ± 0.4 DI s–1; 24.6±2.5 versus 30.8 ± 1.8 DI, respectively). To analyze the effect of heart rate on the DI versus time plots investigations were performed in 7 additional controls at rest and during rapid pacing. Heart rates below 100 bpm did not disturb the DI kinetics at 1:1 triggering.

Conclusions: Myocardial perfusion can be assessed by the analysis of the first pass DI kinetics using Levovist. The estimation of vasodilator response by PDHI seems to be an alternative to the determination of coronary flow reserve.

Keywords: myocardial contrast echocardiography; Power Doppler harmonic imaging; dipyridamole stress; coronary flow reserve


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