It is now possible to perform myocardial contrast echocardiography (MCE) at the bedside with intravenous injection of commercially available contrast media. Detecting coronary stenosis and myocardial viability in patients is the major aim of anMCE study, but its diagnosis has relied largely on subjective interpretation of regional perfusion by experienced readers. Thus, quantifying MCE data and displaying comprehensive images have been be necessary for its routine application. In this review, two methods for quantifying and displaying MCE parameters will be introduced: 1) parametric imaging that separately displays the parameters of myocardial blood volume, blood flow velocity, and myocardial blood flow; and 2) volumetric imaging that displays a color-coded map of myocardial blood volume fraction. Both methods of analysis provide quantitative and easy-to-understand images even to unexperienced observers.
Background. Coronary flow reserve (CFR) was decreased not only in the infarct-related artery, but also in the non-infarct-related arteries (NIRA) in patients with acute myocardial infarction (AMI). However, the clinical value of CFR in NIRA measured after successful percutaneous coronary intervention (PCI) has not been fully clarified. Methods. We studied 27 patients with inferior AMI (AMI group) and 18 patients with no evidence of coronary artery stenosis (control group). Coronary flow velocities in the left anterior descending coronary artery were recorded 1 week after PCI by transthoracic Doppler echocardiography at rest during hyperemia. Regional wall motion was analyzed by the wall motion score index (WMSI), calculated as an average of segmental scores in the RCA territory (R-WMSI) after PCI and at 3 weeks. Results. CFR in the NIRA was significantly lower in the AMI group than in the control group (2.9 ± 0.9 vs. 3.7 ± 0.7, p <0.005). CFR in the NIRA correlated significantly with peak CPK and ΔR-WMSI (r = -0.524, p <0.005, and r = -0.648, p <0.005, respectively). Conclusions. CFR in the NIRA was decreased after AMI after successful PCI
Background. Echocardiography is a reliable procedure for the diagnosis of the isolated noncompaction of the ventricular myocardium (INVM). We studied the demographics and clinical characteristics of echocardiographically diagnosed INVM. Methods. We analyzed two-dimensional and color Doppler echocardiograms in 16,623 consecutive patients from June 2000 to February 2005. Results. There were 99 INVM patients (68 males) with a prevalence was 0.6% (0.7% in males, 0.5% in females). Ten male patients had left ventricular dysfunction. Twenty-nine male patients and 10 female patients had mitral valve prolapse. Of 95 INVM patients, 38 male patients and 20 female patients had thoracic deformity, and 18 male patients and 7 female patients had thoracic deformity and mitral valve prolapse. Conclusions. Echocardiographically diagnosed INVM is not an uncommon disease. Left ventricular function is almost normal in many patients (86.9%). Thoracic deformity and/or mitral valve prolapse are often associated with INVM.
We present a case of a patient with scleroderma with a rare form of cardiac involvement. Transthoracic echocardiography showed a left ventricular (LV) aneurysm in the base of the posterior free-wall. Cardiac catheterization revealed normal coronary arteries with a prominent aneurysm seen on left ventriculogram. Although ventricular dilatation is commonly found in scleroderma, a more serious cardiac complication such as LV aneurysm may also develope.