Myocardial contrast echocardiography with sonicated iopromide (Ultravist 370) before and after coronary angioplasty

Thirty-one patients (3 female, 28 male, mean age 56 years) were investigated with myocardial contrast echocardiography before and after successful PTCA (= less than 30% residual stenosis) of one major coronary artery. 2 ml of sonicated lopromid (Ultravist 370, microbubble-size 6 +/- 4 microns) were injected into the coronary vessel. Before, during and after injection a short-axis view or an apical four chamber view was obtained and recorded on videotape. Computer-assisted videodensitometry was performed in a region of interest placed between endo- and epicardium of the myocardial area supplied by the dilated vessel to analyze contrast decay half-time (t/2), time from onset of opacification to t/2 (T-t/2) and maximal videointensity (Imax). 27 patients (87%) had adequate echorecordings before and after PTCA, no side-effects occurred. Contrast decay half-time and T-t/2 showed a decrease in 21/27 (78%) patients (8.7 +/- 6.1 vs 5.8 +/- 3.7s, p less than 0.001) and in 19/27 (70%) patients (12.0 +/- 8.4 vs 8.7 +/- 5.0 s, p less than 0.002) respectively. Imax was not significantly altered by the intervention. Most of the patients without decrease of t/2 and T-t/2 either had moderate coronary stenosis or a preexisting myocardial infarction in the region supplied by the dilated vessel. Thus contrast echocardiography seems to be suitable to assess alterations in myocardial blood flow during PTCA by determination of contrast decay half-time and T-t/2.