Early diagnosis of coronary microvascular dysfunction by myocardial contrast stress echocardiography
Coronary microvascular dysfunction (CMD) is one of the basic mechanisms of myocardial ischemia. Myocardial contrast echocardiography (MCE) is a bedside technique that utilises microbubbles which remain entirely within the intravascular space and denotes the status of microvascular perfusion within t...
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| Format: | Article |
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AIMS Press
2023-02-01
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| Series: | Mathematical Biosciences and Engineering |
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| Online Access: | https://www.aimspress.com/article/doi/10.3934/mbe.2023339?viewType=HTML |
| _version_ | 1811159716868390912 |
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| author | Jucheng Zhang Minwen Ma Huajun Li Zhaoxia Pu Haipeng Liu Tianhai Huang Huan Cheng Yinglan Gong Yonghua Chu Zhikang Wang Jun Jiang Ling Xia |
| author_facet | Jucheng Zhang Minwen Ma Huajun Li Zhaoxia Pu Haipeng Liu Tianhai Huang Huan Cheng Yinglan Gong Yonghua Chu Zhikang Wang Jun Jiang Ling Xia |
| author_sort | Jucheng Zhang |
| collection | DOAJ |
| description | Coronary microvascular dysfunction (CMD) is one of the basic mechanisms of myocardial ischemia. Myocardial contrast echocardiography (MCE) is a bedside technique that utilises microbubbles which remain entirely within the intravascular space and denotes the status of microvascular perfusion within that region. Some pilot studies suggested that MCE may be used to diagnose CMD, but without further validation. This study is aimed to investigate the diagnostic performance of MCE for the evaluation of CMD. MCE was performed at rest and during adenosine triphosphate stress. ECG triggered real-time frames were acquired in the apical 4-chamber, 3-chamber, 2-chamber, and long-axis imaging planes. These images were imported into Narnar for further processing. Eighty-two participants with suspicion of coronary disease and absence of significant epicardial lesions were prospectively investigated. Thermodilution was used as the gold standard to diagnose CMD. CMD was present in 23 (28%) patients. Myocardial blood flow reserve (MBF) was assessed using MCE. CMD was defined as MBF reserve < 2. The MCE method had a high sensitivity (88.1%) and specificity (95.7%) in the diagnosis of CMD. There was strong agreement with thermodilution (Kappa coefficient was 0.727; 95% CI: 0.57–0.88, p < 0.001). However, the correlation coefficient (r = 0.376; p < 0.001) was not high. |
| first_indexed | 2024-04-10T05:47:01Z |
| format | Article |
| id | doaj.art-f49fdce90680429db091f1e32f918834 |
| institution | Directory Open Access Journal |
| issn | 1551-0018 |
| language | English |
| last_indexed | 2024-04-10T05:47:01Z |
| publishDate | 2023-02-01 |
| publisher | AIMS Press |
| record_format | Article |
| series | Mathematical Biosciences and Engineering |
| spelling | doaj.art-f49fdce90680429db091f1e32f9188342023-03-06T01:35:38ZengAIMS PressMathematical Biosciences and Engineering1551-00182023-02-012057845785810.3934/mbe.2023339Early diagnosis of coronary microvascular dysfunction by myocardial contrast stress echocardiographyJucheng Zhang0Minwen Ma1Huajun Li2Zhaoxia Pu 3Haipeng Liu4Tianhai Huang5Huan Cheng6Yinglan Gong7Yonghua Chu8Zhikang Wang 9 Jun Jiang10Ling Xia 111. Department of Clinical Engineering, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou 310009, China 2. Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou 310009, China3. Department of Clinical Engineering, School of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou 310009, China4. Department of Cardiology, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou 310009, China4. Department of Cardiology, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou 310009, China5. Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom1. Department of Clinical Engineering, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou 310009, China6. Key Laboratory for Biomedical Engineering of Ministry of Education, Institute of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China7. Institute of Wenzhou, Zhejiang University, Wenzhou 325036, China1. Department of Clinical Engineering, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou 310009, China1. Department of Clinical Engineering, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou 310009, China4. Department of Cardiology, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou 310009, China6. Key Laboratory for Biomedical Engineering of Ministry of Education, Institute of Biomedical Engineering, Zhejiang University, Hangzhou 310027, ChinaCoronary microvascular dysfunction (CMD) is one of the basic mechanisms of myocardial ischemia. Myocardial contrast echocardiography (MCE) is a bedside technique that utilises microbubbles which remain entirely within the intravascular space and denotes the status of microvascular perfusion within that region. Some pilot studies suggested that MCE may be used to diagnose CMD, but without further validation. This study is aimed to investigate the diagnostic performance of MCE for the evaluation of CMD. MCE was performed at rest and during adenosine triphosphate stress. ECG triggered real-time frames were acquired in the apical 4-chamber, 3-chamber, 2-chamber, and long-axis imaging planes. These images were imported into Narnar for further processing. Eighty-two participants with suspicion of coronary disease and absence of significant epicardial lesions were prospectively investigated. Thermodilution was used as the gold standard to diagnose CMD. CMD was present in 23 (28%) patients. Myocardial blood flow reserve (MBF) was assessed using MCE. CMD was defined as MBF reserve < 2. The MCE method had a high sensitivity (88.1%) and specificity (95.7%) in the diagnosis of CMD. There was strong agreement with thermodilution (Kappa coefficient was 0.727; 95% CI: 0.57–0.88, p < 0.001). However, the correlation coefficient (r = 0.376; p < 0.001) was not high.https://www.aimspress.com/article/doi/10.3934/mbe.2023339?viewType=HTMLcoronary microvascular dysfunctionmyocardial contrast echocardiographycoronary flow reservemyocardial ischemiamyocardial perfusion |
| spellingShingle | Jucheng Zhang Minwen Ma Huajun Li Zhaoxia Pu Haipeng Liu Tianhai Huang Huan Cheng Yinglan Gong Yonghua Chu Zhikang Wang Jun Jiang Ling Xia Early diagnosis of coronary microvascular dysfunction by myocardial contrast stress echocardiography Mathematical Biosciences and Engineering coronary microvascular dysfunction myocardial contrast echocardiography coronary flow reserve myocardial ischemia myocardial perfusion |
| title | Early diagnosis of coronary microvascular dysfunction by myocardial contrast stress echocardiography |
| title_full | Early diagnosis of coronary microvascular dysfunction by myocardial contrast stress echocardiography |
| title_fullStr | Early diagnosis of coronary microvascular dysfunction by myocardial contrast stress echocardiography |
| title_full_unstemmed | Early diagnosis of coronary microvascular dysfunction by myocardial contrast stress echocardiography |
| title_short | Early diagnosis of coronary microvascular dysfunction by myocardial contrast stress echocardiography |
| title_sort | early diagnosis of coronary microvascular dysfunction by myocardial contrast stress echocardiography |
| topic | coronary microvascular dysfunction myocardial contrast echocardiography coronary flow reserve myocardial ischemia myocardial perfusion |
| url | https://www.aimspress.com/article/doi/10.3934/mbe.2023339?viewType=HTML |
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