Real-time myocardial contrast echocardiography in rat: infusion versus bolus administration.

To compare the feasibility of real-time myocardial contrast echocardiography (MCE) in rats with infusion and bolus administration of a second-generation ultrasound contrast agent BR1. B-mode real-time MCE was performed in 12 Sprague Dawley rats following the BR1 infusion or bolus injection. The myocardium signal intensity (SI) was plotted against time and was fitted to exponential functions. The plateau SI (A) and rate of SI increase (beta) for the infusion study and peak signal intensity (PSI) for the bolus study were obtained. (99m)Tc-Sestamibi and Evans blue were used to assess myocardial blood perfusion and to calculate the myocardium perfusion defect area ex vivo. High-quality real-time MCE images were successfully obtained using each method. At baseline, all LV segments showed even contrast distribution. Following left anterior descending coronary artery (LAD) ligation, significant perfusion defect was observed in LAD beds with a significantly decreased A* beta and PSI values compared with LCx beds (Infusion: A*beta (LAD): 5.42 +/- 1.57 dB, A*beta (LCx): 46.52 +/- 5.32 dB, p < 0.05; Bolus: PSI (LAD): 2.11 +/- 0.67 dB, PSI (LCx): 20.68 +/- 0.72 dB, p < 0.05), which was consistent with (99m)Tc-Sestamibi distribution findings. Myocardial perfusion defect areas, assessed by both methods, showed no differences and showed good correlation with Evans blue staining. ED frames were more favorable for imaging analysis. Both infusion and bolus administration of the contrast agent combined with real-time MCE technique can provide a reliable and noninvasive approach for myocardial perfusion assessment in rats and the infusion method was more suitable for quantitative analysis of myocardial blood flow.

Three- and 4-dimensional ultrasonography in the prenatal evaluation of fetal anomalies associated with trisomy 18.

OBJECTIVE: The purpose of this study was to assess the usefulness of 3- and 4-dimensional ultrasonography (3D/4DUS) for the description of anomalies associated with trisomy 18 and to determine whether 3D/4DUS adds diagnostic information over what is provided by conventional 2-dimensional ultrasonography (2DUS) alone. METHODS: Twenty-six fetuses subsequently proven to have trisomy 18 underwent prenatal ultrasonographic evaluations by both 2DUS and 3D/4DUS. Volume data sets were acquired by the same sonographers after the conventional 2DUS examinations and were explored with 4-dimensional imaging software by another independent examiner blinded to the indications of 2DUS. The findings detected by 2DUS and 3D/4DUS were compared with those acquired at autopsy. The sensitivity of each modality for detecting anomalies was calculated and compared by the McNemar test. RESULTS: Excluding polyhydramnios, there were 131 anomalies confirmed postnatally in 26 fetuses with trisomy 18. There was a statistically significant difference in the sensitivity for detecting anomalies between 3D/4DUS and 2DUS (93.89% versus 73.28%; McNemar value = 23.31; P < .05), especially in anomalies of the face/neck (96.15% versus 65.38%; McNemar value = 6.13; P < .05) and extremities (96.3% versus 48.15%; McNemar value = 11.07; P < .05). Three- and 4-dimensional ultrasonography provided additional diagnostic information for 83.97% of the anomalies related to trisomy 18 and influenced the obstetric management of 4 fetuses. CONCLUSIONS: Three- and 4-dimensional ultrasonography offered diagnostic advantages for many anomalies associated with trisomy 18, especially for anomalies of the extremities and face. This modality could be a powerful adjunct to 2DUS in the prenatal anatomic evaluation of fetuses with trisomy 18.

[Prognostic value of ventricular longitudinal systolic velocities and maximal oxygen consumption in patients with dilated cardiomyopathy].

OBJECTIVE: To compare the prognostic value of regional longitudinal ventricular systolic velocities with that of maximal oxygen consumption (VO(2max)) in patients with dilated cardiomyopathy (DCM). METHODS: VO(2max) derived from cardiopulmonary exercise tests and regional longitudinal ventricular systolic velocities obtained from tissue Doppler imaging were compared in 18 DCM patients with cardiac events (death, cardiac transplantation, hospitalization, group A) and 24 patients without cardiac events (group B). Peak velocities during isovolumic contraction (is) and ejection (ez) were interrogated at the mitral or tricuspid annulus (site 1), at the mid parts of the walls (site 3, at the level of papillary muscle), and at the midpoints (site 2) between sites 1 and 3 of interventricular septum (S), lateral wall of LV (L) and of RV (R) in apical 4 chambers view. RESULTS: R1is, R2is, R2ez, R3is, S1is, S1ez, S2ez, L1is, L1ez and L2ez of group A were significantly lower than those in group B (all P < 0.05). Independent of VO(2max), high sensitivity and specificity were shown for R3ez, S1ez, L1ez, L1is, L2is and L3is in predicting cardiac events of DCM patients. CONCLUSION: LV and RV systolic velocities could independently predict cardiac events in DCM patients.

[Noninvasive assessment of left anterior descending and right coronary artery flow reserve by transthoracic Doppler echocardiography in patients with coronary artery disease].

OBJECTIVE: To assess the feasibility of evaluation of CFR for LAD and right coronary artery (RCA) as well as diagnostic accuracy for patency of each vessel by transthoracic Doppler echocardiography (TTDE). METHODS: 65 consecutive patients (age 58 +/- 14, ejection fraction 49% +/- 8%, 48 men and 17 women) were studied for CFR by TTDE with adenosine infusion (140 microg.kg(-1).min(-1)). LAD flow was interrogated nearby the apex in modified 2-ch apical view. RCA flow was interrogated at mid posterior wall on distal part of the posterior descending branch (PDA) in modified 2-ch apical view for PDA. RESULTS: Flow for LAD was detected in all patients (4 with use of contrast agent) and for RCA in 55 patients (5 with contrast agent). Two patients had an occluded RCA. Feasibility of RCA flow detection was 55/63 (87%). In all patients maximal flow of each branch was detected in less than 2 min of adenosine infusion (140 mg.kg(-1).min(-1)). Total time for both CFR estimation was 7.3 +/- 1.6 min. Selecting 2.0 or 1.8 as CFR cut-off value for diagnosis of coronary stenosis (> or = 50% in diameter) or severe stenosis (> or = 70%) was found fitted for both LAD and RCA with similar diagnostic performance (sensitivity 89%/93%, specificity 86%/84%, area under curve 0.89/0.92 respectively, in stenosis diagnosis and sensitivity 88%/89%, specificity 90%/83%, area under curve 0.94/0.95 respectively in severe stenosis diagnosis). CONCLUSIONS: CFR evaluation of both distal LAD and PDA is of high feasibility and can provide high diagnostic yield for relevant vessel patency.

[Construction of VEGF eukaryotic expression vector and its expression in endothelial cells and cardiac myocytes in-vitro].

AIM: To study the feasibility of VEGF165 gene transfection to endothelial cells and cardiac myocytes in-vitro. METHODS: The VEGF165 DNA fragment was inserted into a green fluorescent protein fusion vector, which was then transfected into endothelial cells and cardiac myocytes with lipofectamine. RESULTS: The endothelial cells and cardiac myocytes were successfully transfected with pIRES2-EGFP-hVEGF165 gene, which was confirmed by fluoroscopy and immunohistochemistry. CONCLUSION: VEGF can be expressed stably in the endothelial cells and cardiac myocytes, which might be useful for the gene therapy of myocardial ischemia.