Heart 1997;78:331-332 ( October )
Editorial
Lessons from myocardial contrast echocardiography studies during primary angioplasty
| The first 150 words of the full text of this article appear below. |
Early recanalisation of an occluded coronary artery to achieve
timely myocardial reperfusion is the main goal of treatment of
myocardial infarction during the acute phase. Successful recanalisation has generally been defined as the angiographic demonstration of early
and complete (TIMI-3 flow) patency of the infarct related artery;
however, angiography has serious limitations for judging of the
efficacy of reperfusion treatment.1 In particular,
patients with a widely patent epicardial coronary vessel often
demonstrate lack of adequate myocardial perfusion, most likely because
of microvascular injury. This "no-reflow" phenomenon was first
described in 1974 by Kloner et al in an animal
model,2 and observed in man in 1992 by Ito et
al using intracoronary myocardial contrast echocardiography
(MCE) performed during primary angioplasty (PTCA) for acute myocardial
infarction.3 Taking advantage of the access to the
coronary circulation offered during primary PTCA, this technique relies
on direct intracoronary injection of contrast agents containing
microbubbles, often using simple
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