American Journal of Cardiology
Volume 79, Issue 10 , Pages 1329-1333, 15 May 1997

Comparison of myocardial contrast echocardiography and coronary angiography for assessing the acute protective effects of collateral recruitment during occlusion of the left anterior descending coronary artery at the time of elective angioplasty

  • Yasuhiko Sakata, MD

      Affiliations

    • Corresponding Author InformationAddress for reprints: Yasuhiko Sakata, MD, Cardiovascular Division, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka 543, Japan.
    • From the Cardiovascular Division, Osaka Police Hospital, Osaka, Japan
    • From the Cardiology Division, Kawachi General Hospital, Higashi-Osaka, Japan
    • From the First Department of Medicine, Osaka University School of Medicine, Suita, Japan
    • ,
  • Kazuhisa Kodama, MD

      Affiliations

    • From the Cardiovascular Division, Osaka Police Hospital, Osaka, Japan
    • From the Cardiology Division, Kawachi General Hospital, Higashi-Osaka, Japan
    • From the First Department of Medicine, Osaka University School of Medicine, Suita, Japan
    • ,
  • Takayoshi Adachi, MD

      Affiliations

    • From the Cardiovascular Division, Osaka Police Hospital, Osaka, Japan
    • From the Cardiology Division, Kawachi General Hospital, Higashi-Osaka, Japan
    • From the First Department of Medicine, Osaka University School of Medicine, Suita, Japan
    • ,
  • Young-Jae Lim, MD

      Affiliations

    • From the Cardiovascular Division, Osaka Police Hospital, Osaka, Japan
    • From the Cardiology Division, Kawachi General Hospital, Higashi-Osaka, Japan
    • From the First Department of Medicine, Osaka University School of Medicine, Suita, Japan
    • ,
  • Fuminobu Ishikura, MD

      Affiliations

    • From the Cardiovascular Division, Osaka Police Hospital, Osaka, Japan
    • From the Cardiology Division, Kawachi General Hospital, Higashi-Osaka, Japan
    • From the First Department of Medicine, Osaka University School of Medicine, Suita, Japan
    • ,
  • Hisakazu Fuji, MD

      Affiliations

    • From the Cardiovascular Division, Osaka Police Hospital, Osaka, Japan
    • From the Cardiology Division, Kawachi General Hospital, Higashi-Osaka, Japan
    • From the First Department of Medicine, Osaka University School of Medicine, Suita, Japan
    • ,
  • Tohru Masuyama, MD

      Affiliations

    • From the Cardiovascular Division, Osaka Police Hospital, Osaka, Japan
    • From the Cardiology Division, Kawachi General Hospital, Higashi-Osaka, Japan
    • From the First Department of Medicine, Osaka University School of Medicine, Suita, Japan
    • ,
  • Atsushi Hirayama, MD

      Affiliations

    • From the Cardiovascular Division, Osaka Police Hospital, Osaka, Japan
    • From the Cardiology Division, Kawachi General Hospital, Higashi-Osaka, Japan
    • From the First Department of Medicine, Osaka University School of Medicine, Suita, Japan

Received 15 October 1996; accepted 27 January 1997.

Abstract 

To assess the immediate change in collateral flow distribution within the occluded myocardium and the acute protective effects on myocardial ischemia after coronary occlusion, myocardial contrast echocardiography (MCE) was performed in 15 patients with normal left ventricular function undergoing elective coronary angioplasty of the left anterior descending artery, and the results were compared with those obtained from coronary angiography (CA). The sonicated or nonsonicated contrast material was injected into the right coronary artery before and during coronary occlusion and collaterals were graded on a 4-point scale (none = 0 to good = 3). Development of subjective anginal symptoms, ST-segment shift and wall motion abnormality during coronary occlusion were graded on a 4-point scale (none = 0 to severe = 3). Both MCE and CA detected a significant development in collateral flow during coronary occlusion. There was no significant correlation between MCE and CA collateral grades before or during coronary occlusion. The collateral flow assessed with MCE was inversely but significantly correlated with development of subjective anginal symptoms (rs = −0.70, p < 0.01), ST-segment shift (rs = −0.78, p < 0.005) or wall motion abnormality (rs = −0.91, p < 0.001) during coronary occlusion. In contrast, the angiographic collateral flow was not correlated with development of anginal symptoms (rs = −0.46, p = 0.10), ST-segment shift (rs = −0.41, p = 0.14), or wall motion abnormality (rs = −0.26, p = 0.35). The present study suggested that the acute protective effects of coronary collaterals during coronary occlusion were closely associated with myocardial perfusion rather than the angiographic epicardial collateral vessel filling, and thus MCE was useful in assessing the acute protective effects of coronary collaterals during coronary occlusion.

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PII: S0002-9149(97)00134-3

American Journal of Cardiology
Volume 79, Issue 10 , Pages 1329-1333, 15 May 1997

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