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Triggered Replenishment Imaging Reduces Variability of Quantitative Myocardial Contrast Echocardiography and Allows Assessment of Myocardial Blood Flow Reserve
Author(s) -
Ghanem Alexander,
DeMaria Anthony N.,
Lohmaier Stefan,
ElSayed Mona A.,
Strachan Monet,
Sommer Torsten,
Stypmann Jörg,
Tiemann Klaus
Publication year - 2007
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.2007.00368.x
Subject(s) - reproducibility , blood flow , microbubbles , coefficient of variation , medicine , cardiology , myocardial perfusion imaging , perfusion , nuclear medicine , ultrasound , biomedical engineering , radiology , mathematics , statistics
Assessment of replenishment kinetics (RK) following ultrasound‐induced destruction of contrast microbubbles allows quantification of myocardial blood flow reserve (MBFR) applying the modelf (t) = A (1 − e ‐ßt ), with parameter β describing mean flow velocity and parameter A representing blood volume. However, few data on the variability and reproducibility of RK in a clinical setting are available. Therefore, we examined 30 patients in a rest—adenosine protocol in one center. Off‐line quantification of real‐time perfusion imaging (RTPI) and triggered replenishment imaging (TRI) was performed at two sites and compared with coronary angiography and flow reserve measurements. Parameter A was found to be robust in all investigated segments (coefficient of variation (CV) < 7.2%± 5.1). Variability was lowest for parameter β using TRI in apical segments (CV 6.5%± 5.2, P < 0.01). Highest CV was found with RTPI in lateral segments (CV β : 39.8%± 40.6). Concerning day‐to‐day reproducibility both methods revealed similar results within range of heterogeneity of myocardial blood flow. Both sites obtained significantly lower MBFR in patients with flow‐limiting CAD, compared to subjects without (P < 0.01). Correlation of both sites showed close relationship (y = 0.88x + 0.45, r = 0.83, P < 0.0001), without systematic bias. TRI significantly reduces variability of RK in quantitative MCE. Assessment of MBFR allows investigator‐independent evaluation of CAD.